| National Provider Identifier [NPI]: | 1417943622 |
| Last Name Of The Provider | JEPPSON |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 901 N CURTIS RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | BOISE |
| Zip Code Of The Provider | 837061394 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pediatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 2364 |
| Number Of Medicare Beneficiaries | 128 |
| Total Submitted Charge Amount | 80450.85 |
| Total Medicare Allowed Amount | 36326.24 |
| Total Medicare Payment Amount | 26433 |
| Total Medicare Standardized Payment Amount | 27124.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 12 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 336.15 |
| Total Drug Medicare AllowedAmount | 336.15 |
| Total Drug Medicare PaymentAmount | 329.43 |
| Total Drug Medicare Standardized Payment Amount | 329.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 2352 |
| Number Of Medicare Beneficiaries With Medical Services | 128 |
| Total Medical Submitted Charge Amount | 80114.7 |
| Total Medical Medicare Allowed Amount | 35990.09 |
| Total Medical Medicare Payment Amount | 26103.57 |
| Total Medical Medicare Standardized Payment Amount | 26794.9 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 82 |
| Number Of Beneficiaries Age 75 to 84 | 27 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 84 |
| Number Of Male Beneficiaries | 44 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 116 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 50 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 31 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 14 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8095 |