| National Provider Identifier [NPI]: | 1174625131 |
| Last Name Of The Provider | HEFFERNON |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1325 COTTONWOOD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WOODLAND |
| Zip Code Of The Provider | 956955131 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 151 |
| Number Of Services | 3355 |
| Number Of Medicare Beneficiaries | 1730 |
| Total Submitted Charge Amount | 582765 |
| Total Medicare Allowed Amount | 148845.19 |
| Total Medicare Payment Amount | 119181.48 |
| Total Medicare Standardized Payment Amount | 115661.58 |
| 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 | 151 |
| Number Of Medical Services | 3355 |
| Number Of Medicare Beneficiaries With Medical Services | 1730 |
| Total Medical Submitted Charge Amount | 582765 |
| Total Medical Medicare Allowed Amount | 148845.19 |
| Total Medical Medicare Payment Amount | 119181.48 |
| Total Medical Medicare Standardized Payment Amount | 115661.58 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 248 |
| Number Of Beneficiaries Age 65 to 74 | 778 |
| Number Of Beneficiaries Age 75 to 84 | 459 |
| Number Of Beneficiaries Age Greater 84 | 245 |
| Number Of Female Beneficiaries | 1093 |
| Number Of Male Beneficiaries | 637 |
| Number Of Non Hispanic White Beneficiaries | 1255 |
| Number Of Black or African American Beneficiaries | 38 |
| Number Of AsianPacific Islander Beneficiaries | 65 |
| Number Of Hispanic Beneficiaries | 325 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1274 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 456 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1898 |