| National Provider Identifier [NPI]: | 1245326933 |
| Last Name Of The Provider | LONG |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 42320 HIGHWAY 195 |
| Street Address 2 Of The Provider | |
| City Of The Provider | HALEYVILLE |
| Zip Code Of The Provider | 35565 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 173 |
| Number Of Services | 15601 |
| Number Of Medicare Beneficiaries | 883 |
| Total Submitted Charge Amount | 718855 |
| Total Medicare Allowed Amount | 535907.6 |
| Total Medicare Payment Amount | 416347.66 |
| Total Medicare Standardized Payment Amount | 436044.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 4268 |
| Number Of Medicare Beneficiaries With Drug Services | 529 |
| Total Drug Submitted ChargeAmount | 48449 |
| Total Drug Medicare AllowedAmount | 19390.82 |
| Total Drug Medicare PaymentAmount | 13983.9 |
| Total Drug Medicare Standardized Payment Amount | 13983.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 157 |
| Number Of Medical Services | 11333 |
| Number Of Medicare Beneficiaries With Medical Services | 883 |
| Total Medical Submitted Charge Amount | 670406 |
| Total Medical Medicare Allowed Amount | 516516.78 |
| Total Medical Medicare Payment Amount | 402363.76 |
| Total Medical Medicare Standardized Payment Amount | 422060.48 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 329 |
| Number Of Beneficiaries Age 65 to 74 | 344 |
| Number Of Beneficiaries Age 75 to 84 | 167 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 493 |
| Number Of Male Beneficiaries | 390 |
| Number Of Non Hispanic White Beneficiaries | 867 |
| 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 | 498 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 385 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 2 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1428 |