National Provider Identifier [NPI]: |
1700818515 |
Last Name Of The Provider |
TRENT |
First Name Of The Provider |
JENNIFER |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5741 BEE RIDGE RD |
Street Address 2 Of The Provider |
SUITE 450 |
City Of The Provider |
SARASOTA |
Zip Code Of The Provider |
342335064 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
32790 |
Number Of Medicare Beneficiaries |
1419 |
Total Submitted Charge Amount |
2030568.4 |
Total Medicare Allowed Amount |
1079108.43 |
Total Medicare Payment Amount |
820016.48 |
Total Medicare Standardized Payment Amount |
810428.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
63 |
Number Of Medicare Beneficiaries With Drug Services |
26 |
Total Drug Submitted ChargeAmount |
1575 |
Total Drug Medicare AllowedAmount |
113 |
Total Drug Medicare PaymentAmount |
88.59 |
Total Drug Medicare Standardized Payment Amount |
88.59 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
32727 |
Number Of Medicare Beneficiaries With Medical Services |
1419 |
Total Medical Submitted Charge Amount |
2028993.4 |
Total Medical Medicare Allowed Amount |
1078995.43 |
Total Medical Medicare Payment Amount |
819927.89 |
Total Medical Medicare Standardized Payment Amount |
810340.32 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
653 |
Number Of Beneficiaries Age 75 to 84 |
530 |
Number Of Beneficiaries Age Greater 84 |
216 |
Number Of Female Beneficiaries |
781 |
Number Of Male Beneficiaries |
638 |
Number Of Non Hispanic White Beneficiaries |
1380 |
Number Of Black or African American Beneficiaries |
|
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 |
19 |
Number Of Beneficiaries With Medicare Only Entitlement |
1406 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
10 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9154 |