| National Provider Identifier [NPI]: | 1790702314 |
| Last Name Of The Provider | LEDBETTER |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1622 8TH AVENUE |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 761044155 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 2496 |
| Number Of Medicare Beneficiaries | 516 |
| Total Submitted Charge Amount | 296351 |
| Total Medicare Allowed Amount | 127603.66 |
| Total Medicare Payment Amount | 82171.8 |
| Total Medicare Standardized Payment Amount | 84056.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 334 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 3073 |
| Total Drug Medicare AllowedAmount | 441.55 |
| Total Drug Medicare PaymentAmount | 324.58 |
| Total Drug Medicare Standardized Payment Amount | 324.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 2162 |
| Number Of Medicare Beneficiaries With Medical Services | 516 |
| Total Medical Submitted Charge Amount | 293278 |
| Total Medical Medicare Allowed Amount | 127162.11 |
| Total Medical Medicare Payment Amount | 81847.22 |
| Total Medical Medicare Standardized Payment Amount | 83731.93 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 249 |
| Number Of Beneficiaries Age 75 to 84 | 153 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 309 |
| Number Of Male Beneficiaries | 207 |
| Number Of Non Hispanic White Beneficiaries | 486 |
| Number Of Black or African American Beneficiaries | 13 |
| 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 | 504 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3343 |