National Provider Identifier [NPI]: |
1821078387 |
Last Name Of The Provider |
JONES |
First Name Of The Provider |
TERRY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1707 BROADMOOR DR |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
BRYAN |
Zip Code Of The Provider |
778025233 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
4123 |
Number Of Medicare Beneficiaries |
722 |
Total Submitted Charge Amount |
289606 |
Total Medicare Allowed Amount |
131426.23 |
Total Medicare Payment Amount |
91032.52 |
Total Medicare Standardized Payment Amount |
93851.04 |
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 |
18 |
Number Of Medical Services |
4123 |
Number Of Medicare Beneficiaries With Medical Services |
722 |
Total Medical Submitted Charge Amount |
289606 |
Total Medical Medicare Allowed Amount |
131426.23 |
Total Medical Medicare Payment Amount |
91032.52 |
Total Medical Medicare Standardized Payment Amount |
93851.04 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
289 |
Number Of Beneficiaries Age 75 to 84 |
281 |
Number Of Beneficiaries Age Greater 84 |
131 |
Number Of Female Beneficiaries |
333 |
Number Of Male Beneficiaries |
389 |
Number Of Non Hispanic White Beneficiaries |
685 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
699 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9333 |