National Provider Identifier [NPI]: |
1922001742 |
Last Name Of The Provider |
MCJENNETT |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1200 7TH AVE N |
Street Address 2 Of The Provider |
|
City Of The Provider |
ST PETERSBURG |
Zip Code Of The Provider |
337051300 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
981 |
Number Of Medicare Beneficiaries |
672 |
Total Submitted Charge Amount |
764095 |
Total Medicare Allowed Amount |
118212.1 |
Total Medicare Payment Amount |
90792.69 |
Total Medicare Standardized Payment Amount |
89357.94 |
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 |
28 |
Number Of Medical Services |
981 |
Number Of Medicare Beneficiaries With Medical Services |
672 |
Total Medical Submitted Charge Amount |
764095 |
Total Medical Medicare Allowed Amount |
118212.1 |
Total Medical Medicare Payment Amount |
90792.69 |
Total Medical Medicare Standardized Payment Amount |
89357.94 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
167 |
Number Of Beneficiaries Age 65 to 74 |
171 |
Number Of Beneficiaries Age 75 to 84 |
178 |
Number Of Beneficiaries Age Greater 84 |
156 |
Number Of Female Beneficiaries |
391 |
Number Of Male Beneficiaries |
281 |
Number Of Non Hispanic White Beneficiaries |
493 |
Number Of Black or African American Beneficiaries |
91 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
70 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
416 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
256 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
23 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.7696 |