National Provider Identifier [NPI]: |
1760478838 |
Last Name Of The Provider |
JONES |
First Name Of The Provider |
CARL |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1018 N MOUND ST |
Street Address 2 Of The Provider |
#206 |
City Of The Provider |
NACOGDOCHES |
Zip Code Of The Provider |
759614492 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
2582 |
Number Of Medicare Beneficiaries |
883 |
Total Submitted Charge Amount |
939281.99 |
Total Medicare Allowed Amount |
325417.12 |
Total Medicare Payment Amount |
244729.92 |
Total Medicare Standardized Payment Amount |
257673.76 |
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 |
50 |
Number Of Medical Services |
2582 |
Number Of Medicare Beneficiaries With Medical Services |
883 |
Total Medical Submitted Charge Amount |
939281.99 |
Total Medical Medicare Allowed Amount |
325417.12 |
Total Medical Medicare Payment Amount |
244729.92 |
Total Medical Medicare Standardized Payment Amount |
257673.76 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
195 |
Number Of Beneficiaries Age 65 to 74 |
347 |
Number Of Beneficiaries Age 75 to 84 |
234 |
Number Of Beneficiaries Age Greater 84 |
107 |
Number Of Female Beneficiaries |
549 |
Number Of Male Beneficiaries |
334 |
Number Of Non Hispanic White Beneficiaries |
675 |
Number Of Black or African American Beneficiaries |
177 |
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 |
605 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
278 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.639 |