National Provider Identifier [NPI]: |
1538158365 |
Last Name Of The Provider |
JENKS |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
930 E CAMPBELL RD |
Street Address 2 Of The Provider |
SUITE 106 |
City Of The Provider |
RICHARDSON |
Zip Code Of The Provider |
750812047 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
613 |
Number Of Medicare Beneficiaries |
153 |
Total Submitted Charge Amount |
67158.02 |
Total Medicare Allowed Amount |
36351.72 |
Total Medicare Payment Amount |
25119.3 |
Total Medicare Standardized Payment Amount |
24917.76 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
226 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
3066 |
Total Drug Medicare AllowedAmount |
383.46 |
Total Drug Medicare PaymentAmount |
323.19 |
Total Drug Medicare Standardized Payment Amount |
323.19 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
387 |
Number Of Medicare Beneficiaries With Medical Services |
153 |
Total Medical Submitted Charge Amount |
64092.02 |
Total Medical Medicare Allowed Amount |
35968.26 |
Total Medical Medicare Payment Amount |
24796.11 |
Total Medical Medicare Standardized Payment Amount |
24594.57 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
93 |
Number Of Male Beneficiaries |
60 |
Number Of Non Hispanic White Beneficiaries |
130 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
140 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9127 |