National Provider Identifier [NPI]: |
1962495994 |
Last Name Of The Provider |
JENKINS |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1025 S 2ND AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
WALLA WALLA |
Zip Code Of The Provider |
993624116 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
680 |
Number Of Medicare Beneficiaries |
500 |
Total Submitted Charge Amount |
296907 |
Total Medicare Allowed Amount |
69316.2 |
Total Medicare Payment Amount |
50652.69 |
Total Medicare Standardized Payment Amount |
53974.83 |
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 |
35 |
Number Of Medical Services |
680 |
Number Of Medicare Beneficiaries With Medical Services |
500 |
Total Medical Submitted Charge Amount |
296907 |
Total Medical Medicare Allowed Amount |
69316.2 |
Total Medical Medicare Payment Amount |
50652.69 |
Total Medical Medicare Standardized Payment Amount |
53974.83 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
90 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
138 |
Number Of Beneficiaries Age Greater 84 |
147 |
Number Of Female Beneficiaries |
320 |
Number Of Male Beneficiaries |
180 |
Number Of Non Hispanic White Beneficiaries |
453 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
347 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
153 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.4504 |