National Provider Identifier [NPI]: |
1609001940 |
Last Name Of The Provider |
MCDOWELL |
First Name Of The Provider |
JACOB |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3132 WEST MARCH LANE |
Street Address 2 Of The Provider |
SUITE 5 |
City Of The Provider |
STOCKTON |
Zip Code Of The Provider |
952192354 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
1369 |
Number Of Medicare Beneficiaries |
456 |
Total Submitted Charge Amount |
270501 |
Total Medicare Allowed Amount |
125121.7 |
Total Medicare Payment Amount |
97910.51 |
Total Medicare Standardized Payment Amount |
97503.4 |
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 |
16 |
Number Of Medical Services |
1369 |
Number Of Medicare Beneficiaries With Medical Services |
456 |
Total Medical Submitted Charge Amount |
270501 |
Total Medical Medicare Allowed Amount |
125121.7 |
Total Medical Medicare Payment Amount |
97910.51 |
Total Medical Medicare Standardized Payment Amount |
97503.4 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
129 |
Number Of Beneficiaries Age 75 to 84 |
133 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
244 |
Number Of Male Beneficiaries |
212 |
Number Of Non Hispanic White Beneficiaries |
249 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
62 |
Number Of Hispanic Beneficiaries |
91 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
202 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
254 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.4317 |