National Provider Identifier [NPI]: |
1619934296 |
Last Name Of The Provider |
JONES |
First Name Of The Provider |
PETER |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
14 QUARRY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WILLIMANTIC |
Zip Code Of The Provider |
062261232 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
11257 |
Number Of Medicare Beneficiaries |
511 |
Total Submitted Charge Amount |
868629.7 |
Total Medicare Allowed Amount |
543441.48 |
Total Medicare Payment Amount |
410915.98 |
Total Medicare Standardized Payment Amount |
388227.43 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
466 |
Number Of Medicare Beneficiaries With Drug Services |
264 |
Total Drug Submitted ChargeAmount |
11215.5 |
Total Drug Medicare AllowedAmount |
6574.36 |
Total Drug Medicare PaymentAmount |
6239.13 |
Total Drug Medicare Standardized Payment Amount |
6239.13 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
63 |
Number Of Medical Services |
10791 |
Number Of Medicare Beneficiaries With Medical Services |
511 |
Total Medical Submitted Charge Amount |
857414.2 |
Total Medical Medicare Allowed Amount |
536867.12 |
Total Medical Medicare Payment Amount |
404676.85 |
Total Medical Medicare Standardized Payment Amount |
381988.3 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
171 |
Number Of Beneficiaries Age 75 to 84 |
164 |
Number Of Beneficiaries Age Greater 84 |
144 |
Number Of Female Beneficiaries |
282 |
Number Of Male Beneficiaries |
229 |
Number Of Non Hispanic White Beneficiaries |
477 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
367 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
144 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4071 |