National Provider Identifier [NPI]: |
1164528204 |
Last Name Of The Provider |
JENKINS |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2828 N NATIONAL AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658034306 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
986 |
Number Of Medicare Beneficiaries |
314 |
Total Submitted Charge Amount |
115976 |
Total Medicare Allowed Amount |
60648.01 |
Total Medicare Payment Amount |
47001.39 |
Total Medicare Standardized Payment Amount |
51061.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
986 |
Number Of Medicare Beneficiaries With Medical Services |
314 |
Total Medical Submitted Charge Amount |
115976 |
Total Medical Medicare Allowed Amount |
60648.01 |
Total Medical Medicare Payment Amount |
47001.39 |
Total Medical Medicare Standardized Payment Amount |
51061.86 |
Average Age Of Beneficiaries |
55 |
Number Of Beneficiaries Age Less65 |
234 |
Number Of Beneficiaries Age 65 to 74 |
47 |
Number Of Beneficiaries Age 75 to 84 |
20 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
197 |
Number Of Male Beneficiaries |
117 |
Number Of Non Hispanic White Beneficiaries |
289 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
53 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
261 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
41 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4933 |