National Provider Identifier [NPI]: |
1760410005 |
Last Name Of The Provider |
JENKINS |
First Name Of The Provider |
WARREN |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2840 LEGACY DR |
Street Address 2 Of The Provider |
BLDG 400 |
City Of The Provider |
FRISCO |
Zip Code Of The Provider |
750346049 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
781 |
Number Of Medicare Beneficiaries |
162 |
Total Submitted Charge Amount |
58432.95 |
Total Medicare Allowed Amount |
35247.03 |
Total Medicare Payment Amount |
24762.14 |
Total Medicare Standardized Payment Amount |
26466.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
95 |
Number Of Medicare Beneficiaries With Drug Services |
57 |
Total Drug Submitted ChargeAmount |
2133.4 |
Total Drug Medicare AllowedAmount |
1473.71 |
Total Drug Medicare PaymentAmount |
1430.53 |
Total Drug Medicare Standardized Payment Amount |
1430.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
686 |
Number Of Medicare Beneficiaries With Medical Services |
162 |
Total Medical Submitted Charge Amount |
56299.55 |
Total Medical Medicare Allowed Amount |
33773.32 |
Total Medical Medicare Payment Amount |
23331.61 |
Total Medical Medicare Standardized Payment Amount |
25035.8 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
99 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
72 |
Number Of Male Beneficiaries |
90 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
9 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7536 |