National Provider Identifier [NPI]: |
1497074058 |
Last Name Of The Provider |
HOLMES |
First Name Of The Provider |
JESSE |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1300 MICCOSUKEE ROAD |
Street Address 2 Of The Provider |
HOSPITALISTS GROUP |
City Of The Provider |
TALLAHASSEE |
Zip Code Of The Provider |
32308 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
803 |
Number Of Medicare Beneficiaries |
338 |
Total Submitted Charge Amount |
116575 |
Total Medicare Allowed Amount |
77498.09 |
Total Medicare Payment Amount |
60363.16 |
Total Medicare Standardized Payment Amount |
59915.59 |
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 |
18 |
Number Of Medical Services |
803 |
Number Of Medicare Beneficiaries With Medical Services |
338 |
Total Medical Submitted Charge Amount |
116575 |
Total Medical Medicare Allowed Amount |
77498.09 |
Total Medical Medicare Payment Amount |
60363.16 |
Total Medical Medicare Standardized Payment Amount |
59915.59 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
110 |
Number Of Beneficiaries Age Greater 84 |
84 |
Number Of Female Beneficiaries |
200 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
248 |
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 |
225 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
113 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.1041 |