National Provider Identifier [NPI]: |
1265497804 |
Last Name Of The Provider |
VESPER |
First Name Of The Provider |
JENNIFER |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
300 RIVERSIDE DR E |
Street Address 2 Of The Provider |
#2200 |
City Of The Provider |
BRADENTON |
Zip Code Of The Provider |
342081008 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
4932 |
Number Of Medicare Beneficiaries |
849 |
Total Submitted Charge Amount |
416806 |
Total Medicare Allowed Amount |
282540.21 |
Total Medicare Payment Amount |
211177.65 |
Total Medicare Standardized Payment Amount |
208937.1 |
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 |
66 |
Number Of Medical Services |
4932 |
Number Of Medicare Beneficiaries With Medical Services |
849 |
Total Medical Submitted Charge Amount |
416806 |
Total Medical Medicare Allowed Amount |
282540.21 |
Total Medical Medicare Payment Amount |
211177.65 |
Total Medical Medicare Standardized Payment Amount |
208937.1 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
457 |
Number Of Beneficiaries Age Greater 84 |
219 |
Number Of Female Beneficiaries |
517 |
Number Of Male Beneficiaries |
332 |
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 |
832 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
17 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1171 |