National Provider Identifier [NPI]: |
1629089107 |
Last Name Of The Provider |
JAFFE |
First Name Of The Provider |
MARK |
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 |
6410 ROCKLEDGE DRIVE |
Street Address 2 Of The Provider |
SUITE 402 |
City Of The Provider |
BETHESDA |
Zip Code Of The Provider |
20817 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
67 |
Number Of Services |
4202 |
Number Of Medicare Beneficiaries |
1065 |
Total Submitted Charge Amount |
458147 |
Total Medicare Allowed Amount |
329969.82 |
Total Medicare Payment Amount |
241422.31 |
Total Medicare Standardized Payment Amount |
203915.92 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
78 |
Number Of Medicare Beneficiaries With Drug Services |
42 |
Total Drug Submitted ChargeAmount |
1286 |
Total Drug Medicare AllowedAmount |
166.64 |
Total Drug Medicare PaymentAmount |
116.24 |
Total Drug Medicare Standardized Payment Amount |
116.24 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
64 |
Number Of Medical Services |
4124 |
Number Of Medicare Beneficiaries With Medical Services |
1065 |
Total Medical Submitted Charge Amount |
456861 |
Total Medical Medicare Allowed Amount |
329803.18 |
Total Medical Medicare Payment Amount |
241306.07 |
Total Medical Medicare Standardized Payment Amount |
203799.68 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
542 |
Number Of Beneficiaries Age 75 to 84 |
373 |
Number Of Beneficiaries Age Greater 84 |
136 |
Number Of Female Beneficiaries |
639 |
Number Of Male Beneficiaries |
426 |
Number Of Non Hispanic White Beneficiaries |
980 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
42 |
Number Of Beneficiaries With Medicare Only Entitlement |
1051 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.853 |