National Provider Identifier [NPI]: |
1710924790 |
Last Name Of The Provider |
JONES |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3015 N BALLAS RD |
Street Address 2 Of The Provider |
ATTN: ED DIRECTOR OFFICE |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631312329 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
741 |
Number Of Medicare Beneficiaries |
692 |
Total Submitted Charge Amount |
410305 |
Total Medicare Allowed Amount |
107925.13 |
Total Medicare Payment Amount |
80553.66 |
Total Medicare Standardized Payment Amount |
81393.21 |
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 |
18 |
Number Of Medical Services |
741 |
Number Of Medicare Beneficiaries With Medical Services |
692 |
Total Medical Submitted Charge Amount |
410305 |
Total Medical Medicare Allowed Amount |
107925.13 |
Total Medical Medicare Payment Amount |
80553.66 |
Total Medical Medicare Standardized Payment Amount |
81393.21 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
195 |
Number Of Beneficiaries Age 75 to 84 |
230 |
Number Of Beneficiaries Age Greater 84 |
180 |
Number Of Female Beneficiaries |
407 |
Number Of Male Beneficiaries |
285 |
Number Of Non Hispanic White Beneficiaries |
584 |
Number Of Black or African American Beneficiaries |
89 |
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 |
597 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
95 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.9626 |