Medicare Facts for Dr. Kelley R. Jewett, MD


National Provider Identifier [NPI]: 1396747788
Last Name Of The Provider JEWETT
First Name Of The Provider KELLEY
Middle Initial Of The Provider R
Credentials Of The Provider MD
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 409 DUNLAP ST N
Street Address 2 Of The Provider
City Of The Provider SAINT PAUL
Zip Code Of The Provider 551044201
State Code Of The Provider MN
Country Code Of The Provider US
Provider Type Of The Provider Family Practice
Medicare Participation Indicator Y
Number Of HCPCS 36
Number Of Services 385
Number Of Medicare Beneficiaries 60
Total Submitted Charge Amount 51512
Total Medicare Allowed Amount 22813.6
Total Medicare Payment Amount 15965.49
Total Medicare Standardized Payment Amount 16274.72
Drug Suppress Indicator
Number Of HCPCS Associated With Drug Services 5
Number Of Drug Services 45
Number Of Medicare Beneficiaries With Drug Services 22
Total Drug Submitted ChargeAmount 609
Total Drug Medicare AllowedAmount 407
Total Drug Medicare PaymentAmount 393.25
Total Drug Medicare Standardized Payment Amount 393.25
Medical SuppressIndicator
Number Of HCPCS Associated With MedicalServices 31
Number Of Medical Services 340
Number Of Medicare Beneficiaries With Medical Services 60
Total Medical Submitted Charge Amount 50903
Total Medical Medicare Allowed Amount 22406.6
Total Medical Medicare Payment Amount 15572.24
Total Medical Medicare Standardized Payment Amount 15881.47
Average Age Of Beneficiaries 59
Number Of Beneficiaries Age Less65 41
Number Of Beneficiaries Age 65 to 74
Number Of Beneficiaries Age 75 to 84
Number Of Beneficiaries Age Greater 84
Number Of Female Beneficiaries 43
Number Of Male Beneficiaries 17
Number Of Non Hispanic White Beneficiaries 28
Number Of Black or African American Beneficiaries
Number Of AsianPacific Islander Beneficiaries 19
Number Of Hispanic Beneficiaries 0
Number Of American Indian Alaska Native Beneficiaries 0
Number Of Beneficiaries With Race Not Else where Classified
Number Of Beneficiaries With Medicare Only Entitlement 19
Number Of Beneficiaries With Medicare Medicaid Entitlement 41
Percent Of With Atrial Fibrillation 0
Percent Of With Alzheimers Disease or Dementia
Percent Of With Asthma
Percent Of With Cancer
Percent Of With Heart Failure
Percent Of With Chronic Kidney Disease 27
Percent Of With Chronic Obstructive Pulmonary Disease
Percent Of With Depression 45
Percent Of With Diabetes 28
Percent Of With Hyperlipidemia 25
Percent Of With Hypertension 37
Percent Of With Ischemic Heart Disease
Percent Of With Osteoporosis 0
Percent Of With Rheumatoid Arthritis Osteoarthritis 37
Percent Of With Schizophrenia Other PsychoticDisorders
Percent Of With Stroke 0
Average HCC Risk Score Of Beneficiaries 1.295

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