National Provider Identifier [NPI]: |
1396803334 |
Last Name Of The Provider |
JENKINS |
First Name Of The Provider |
JULIA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4962 RIDGEMOOR BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PALM HARBOR |
Zip Code Of The Provider |
346851744 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
1081 |
Number Of Medicare Beneficiaries |
178 |
Total Submitted Charge Amount |
142045 |
Total Medicare Allowed Amount |
83887.69 |
Total Medicare Payment Amount |
62641.45 |
Total Medicare Standardized Payment Amount |
63641.12 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
195 |
Number Of Medicare Beneficiaries With Drug Services |
83 |
Total Drug Submitted ChargeAmount |
5767 |
Total Drug Medicare AllowedAmount |
2812.77 |
Total Drug Medicare PaymentAmount |
2737.59 |
Total Drug Medicare Standardized Payment Amount |
2737.59 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
886 |
Number Of Medicare Beneficiaries With Medical Services |
178 |
Total Medical Submitted Charge Amount |
136278 |
Total Medical Medicare Allowed Amount |
81074.92 |
Total Medical Medicare Payment Amount |
59903.86 |
Total Medical Medicare Standardized Payment Amount |
60903.53 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
117 |
Number Of Male Beneficiaries |
61 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2023 |