National Provider Identifier [NPI]: |
1164465647 |
Last Name Of The Provider |
JONES |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6360 S 3000 E |
Street Address 2 Of The Provider |
#310 |
City Of The Provider |
SALT LAKE CITY |
Zip Code Of The Provider |
841216923 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
499 |
Number Of Medicare Beneficiaries |
220 |
Total Submitted Charge Amount |
208977.01 |
Total Medicare Allowed Amount |
68296.87 |
Total Medicare Payment Amount |
51939.36 |
Total Medicare Standardized Payment Amount |
54020.8 |
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 |
33 |
Number Of Medical Services |
499 |
Number Of Medicare Beneficiaries With Medical Services |
220 |
Total Medical Submitted Charge Amount |
208977.01 |
Total Medical Medicare Allowed Amount |
68296.87 |
Total Medical Medicare Payment Amount |
51939.36 |
Total Medical Medicare Standardized Payment Amount |
54020.8 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
113 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
121 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
193 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
189 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6936 |