National Provider Identifier [NPI]: |
1184679896 |
Last Name Of The Provider |
HESS |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 JEFFERSON AVE SE |
Street Address 2 Of The Provider |
6 SOUTH #626 |
City Of The Provider |
GRAND RAPIDS |
Zip Code Of The Provider |
495034502 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
1155 |
Number Of Medicare Beneficiaries |
415 |
Total Submitted Charge Amount |
195618 |
Total Medicare Allowed Amount |
129379.48 |
Total Medicare Payment Amount |
99389.62 |
Total Medicare Standardized Payment Amount |
101753.2 |
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 |
12 |
Number Of Medical Services |
1155 |
Number Of Medicare Beneficiaries With Medical Services |
415 |
Total Medical Submitted Charge Amount |
195618 |
Total Medical Medicare Allowed Amount |
129379.48 |
Total Medical Medicare Payment Amount |
99389.62 |
Total Medical Medicare Standardized Payment Amount |
101753.2 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
136 |
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
226 |
Number Of Male Beneficiaries |
189 |
Number Of Non Hispanic White Beneficiaries |
318 |
Number Of Black or African American Beneficiaries |
64 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
215 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
200 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
63 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
21 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.6888 |