National Provider Identifier [NPI]: |
1689766180 |
Last Name Of The Provider |
JONES |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2508 SOUTH CEDAR |
Street Address 2 Of The Provider |
|
City Of The Provider |
LANSING |
Zip Code Of The Provider |
48910 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
923 |
Number Of Medicare Beneficiaries |
521 |
Total Submitted Charge Amount |
87561.08 |
Total Medicare Allowed Amount |
47867.15 |
Total Medicare Payment Amount |
37423.52 |
Total Medicare Standardized Payment Amount |
31278.86 |
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 |
19 |
Number Of Medical Services |
923 |
Number Of Medicare Beneficiaries With Medical Services |
521 |
Total Medical Submitted Charge Amount |
87561.08 |
Total Medical Medicare Allowed Amount |
47867.15 |
Total Medical Medicare Payment Amount |
37423.52 |
Total Medical Medicare Standardized Payment Amount |
31278.86 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
241 |
Number Of Beneficiaries Age 75 to 84 |
139 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
274 |
Number Of Male Beneficiaries |
247 |
Number Of Non Hispanic White Beneficiaries |
490 |
Number Of Black or African American Beneficiaries |
14 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
446 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
0.9739 |