National Provider Identifier [NPI]: |
1437160538 |
Last Name Of The Provider |
KERR |
First Name Of The Provider |
DARREL |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
815 COURT ST |
Street Address 2 Of The Provider |
STE 7 |
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
956422154 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
1944 |
Number Of Medicare Beneficiaries |
446 |
Total Submitted Charge Amount |
456585 |
Total Medicare Allowed Amount |
166295.61 |
Total Medicare Payment Amount |
116933.2 |
Total Medicare Standardized Payment Amount |
112836.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
144 |
Number Of Medicare Beneficiaries With Drug Services |
73 |
Total Drug Submitted ChargeAmount |
3836 |
Total Drug Medicare AllowedAmount |
2563.38 |
Total Drug Medicare PaymentAmount |
2479.45 |
Total Drug Medicare Standardized Payment Amount |
2479.45 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
1800 |
Number Of Medicare Beneficiaries With Medical Services |
446 |
Total Medical Submitted Charge Amount |
452749 |
Total Medical Medicare Allowed Amount |
163732.23 |
Total Medical Medicare Payment Amount |
114453.75 |
Total Medical Medicare Standardized Payment Amount |
110357.02 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
168 |
Number Of Beneficiaries Age 75 to 84 |
165 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
253 |
Number Of Male Beneficiaries |
193 |
Number Of Non Hispanic White Beneficiaries |
423 |
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 |
431 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9459 |