National Provider Identifier [NPI]: |
1922382159 |
Last Name Of The Provider |
KERENSKY |
First Name Of The Provider |
JESSICA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1600 SW ARCHER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GAINESVILLE |
Zip Code Of The Provider |
326103003 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
108 |
Number Of Medicare Beneficiaries |
102 |
Total Submitted Charge Amount |
35388 |
Total Medicare Allowed Amount |
11626.05 |
Total Medicare Payment Amount |
8521.25 |
Total Medicare Standardized Payment Amount |
9866.2 |
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 |
12 |
Number Of Medical Services |
108 |
Number Of Medicare Beneficiaries With Medical Services |
102 |
Total Medical Submitted Charge Amount |
35388 |
Total Medical Medicare Allowed Amount |
11626.05 |
Total Medical Medicare Payment Amount |
8521.25 |
Total Medical Medicare Standardized Payment Amount |
9866.2 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
73 |
Number Of Male Beneficiaries |
29 |
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 |
66 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5563 |