| National Provider Identifier [NPI]: | 1447249172 |
| Last Name Of The Provider | HUMBARGER |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 320 PARK AVE. |
| Street Address 2 Of The Provider | |
| City Of The Provider | BOCA GRANDE |
| Zip Code Of The Provider | 339210517 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 2174 |
| Number Of Medicare Beneficiaries | 618 |
| Total Submitted Charge Amount | 106119.31 |
| Total Medicare Allowed Amount | 93123.56 |
| Total Medicare Payment Amount | 63569.39 |
| Total Medicare Standardized Payment Amount | 64305.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 134 |
| Number Of Medicare Beneficiaries With Drug Services | 104 |
| Total Drug Submitted ChargeAmount | 2135.76 |
| Total Drug Medicare AllowedAmount | 2125.03 |
| Total Drug Medicare PaymentAmount | 2022.52 |
| Total Drug Medicare Standardized Payment Amount | 2022.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 2040 |
| Number Of Medicare Beneficiaries With Medical Services | 618 |
| Total Medical Submitted Charge Amount | 103983.55 |
| Total Medical Medicare Allowed Amount | 90998.53 |
| Total Medical Medicare Payment Amount | 61546.87 |
| Total Medical Medicare Standardized Payment Amount | 62283.46 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 254 |
| Number Of Beneficiaries Age 75 to 84 | 262 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 304 |
| Number Of Male Beneficiaries | 314 |
| Number Of Non Hispanic White Beneficiaries | 601 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0054 |