National Provider Identifier [NPI]: |
1124016225 |
Last Name Of The Provider |
JAFFE |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
51 N 39TH ST |
Street Address 2 Of The Provider |
SUITE 300 MOB |
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191042640 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
67 |
Number Of Services |
1809 |
Number Of Medicare Beneficiaries |
690 |
Total Submitted Charge Amount |
445059 |
Total Medicare Allowed Amount |
160064.83 |
Total Medicare Payment Amount |
120273.54 |
Total Medicare Standardized Payment Amount |
114880.33 |
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 |
67 |
Number Of Medical Services |
1809 |
Number Of Medicare Beneficiaries With Medical Services |
690 |
Total Medical Submitted Charge Amount |
445059 |
Total Medical Medicare Allowed Amount |
160064.83 |
Total Medical Medicare Payment Amount |
120273.54 |
Total Medical Medicare Standardized Payment Amount |
114880.33 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
131 |
Number Of Beneficiaries Age 65 to 74 |
352 |
Number Of Beneficiaries Age 75 to 84 |
168 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
84 |
Number Of Male Beneficiaries |
606 |
Number Of Non Hispanic White Beneficiaries |
460 |
Number Of Black or African American Beneficiaries |
177 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
25 |
Number Of Beneficiaries With Medicare Only Entitlement |
559 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
32 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5979 |