National Provider Identifier [NPI]: |
1376592469 |
Last Name Of The Provider |
JENKINS |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
333 N. RIVERSHIRE DR. |
Street Address 2 Of The Provider |
SUITE 160 |
City Of The Provider |
CONROE |
Zip Code Of The Provider |
773042711 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
2918 |
Number Of Medicare Beneficiaries |
1395 |
Total Submitted Charge Amount |
2126058 |
Total Medicare Allowed Amount |
429124.33 |
Total Medicare Payment Amount |
305564.94 |
Total Medicare Standardized Payment Amount |
329883.04 |
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 |
24 |
Number Of Medical Services |
2918 |
Number Of Medicare Beneficiaries With Medical Services |
1395 |
Total Medical Submitted Charge Amount |
2126058 |
Total Medical Medicare Allowed Amount |
429124.33 |
Total Medical Medicare Payment Amount |
305564.94 |
Total Medical Medicare Standardized Payment Amount |
329883.04 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
594 |
Number Of Beneficiaries Age 75 to 84 |
558 |
Number Of Beneficiaries Age Greater 84 |
209 |
Number Of Female Beneficiaries |
835 |
Number Of Male Beneficiaries |
560 |
Number Of Non Hispanic White Beneficiaries |
1311 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
42 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1352 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0179 |