| National Provider Identifier [NPI]: | 1649296278 |
| Last Name Of The Provider | JENKS |
| First Name Of The Provider | JERRY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 79 MAPLE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | PLATTE CITY |
| Zip Code Of The Provider | 640799640 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 1784 |
| Number Of Medicare Beneficiaries | 1706 |
| Total Submitted Charge Amount | 231785 |
| Total Medicare Allowed Amount | 201913.64 |
| Total Medicare Payment Amount | 141156.04 |
| Total Medicare Standardized Payment Amount | 148984.36 |
| 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 | 10 |
| Number Of Medical Services | 1784 |
| Number Of Medicare Beneficiaries With Medical Services | 1706 |
| Total Medical Submitted Charge Amount | 231785 |
| Total Medical Medicare Allowed Amount | 201913.64 |
| Total Medical Medicare Payment Amount | 141156.04 |
| Total Medical Medicare Standardized Payment Amount | 148984.36 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 409 |
| Number Of Beneficiaries Age 65 to 74 | 290 |
| Number Of Beneficiaries Age 75 to 84 | 395 |
| Number Of Beneficiaries Age Greater 84 | 612 |
| Number Of Female Beneficiaries | 1030 |
| Number Of Male Beneficiaries | 676 |
| Number Of Non Hispanic White Beneficiaries | 1447 |
| Number Of Black or African American Beneficiaries | 213 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 331 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1375 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 68 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 57 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 38 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.0425 |