National Provider Identifier [NPI]: |
1831352418 |
Last Name Of The Provider |
YOON |
First Name Of The Provider |
JESSICA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1714 MAHAN CENTER BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TALLAHASSEE |
Zip Code Of The Provider |
323085427 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
2766 |
Number Of Medicare Beneficiaries |
332 |
Total Submitted Charge Amount |
400791 |
Total Medicare Allowed Amount |
169990.44 |
Total Medicare Payment Amount |
125641.4 |
Total Medicare Standardized Payment Amount |
124499.04 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
48 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
784 |
Total Drug Medicare AllowedAmount |
573.71 |
Total Drug Medicare PaymentAmount |
449.78 |
Total Drug Medicare Standardized Payment Amount |
449.78 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
2718 |
Number Of Medicare Beneficiaries With Medical Services |
332 |
Total Medical Submitted Charge Amount |
400007 |
Total Medical Medicare Allowed Amount |
169416.73 |
Total Medical Medicare Payment Amount |
125191.62 |
Total Medical Medicare Standardized Payment Amount |
124049.26 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
164 |
Number Of Beneficiaries Age 75 to 84 |
113 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
222 |
Number Of Male Beneficiaries |
110 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
319 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.91 |