National Provider Identifier [NPI]: |
1265423768 |
Last Name Of The Provider |
MEFFERT |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7703 FLOYD CURL DR |
Street Address 2 Of The Provider |
MC797 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782293901 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
1743 |
Number Of Medicare Beneficiaries |
395 |
Total Submitted Charge Amount |
189746 |
Total Medicare Allowed Amount |
74577.48 |
Total Medicare Payment Amount |
52278.78 |
Total Medicare Standardized Payment Amount |
54643.54 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
110 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
3742 |
Total Drug Medicare AllowedAmount |
2159.46 |
Total Drug Medicare PaymentAmount |
1676.37 |
Total Drug Medicare Standardized Payment Amount |
1676.37 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
1633 |
Number Of Medicare Beneficiaries With Medical Services |
395 |
Total Medical Submitted Charge Amount |
186004 |
Total Medical Medicare Allowed Amount |
72418.02 |
Total Medical Medicare Payment Amount |
50602.41 |
Total Medical Medicare Standardized Payment Amount |
52967.17 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
105 |
Number Of Beneficiaries Age 65 to 74 |
165 |
Number Of Beneficiaries Age 75 to 84 |
91 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
198 |
Number Of Male Beneficiaries |
197 |
Number Of Non Hispanic White Beneficiaries |
228 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
142 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
272 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
123 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.3713 |