National Provider Identifier [NPI]: |
1578549200 |
Last Name Of The Provider |
JERKOVICH |
First Name Of The Provider |
GEORGE |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 S SANTA FE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SALINA |
Zip Code Of The Provider |
674014144 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1708 |
Number Of Medicare Beneficiaries |
394 |
Total Submitted Charge Amount |
235453.5 |
Total Medicare Allowed Amount |
131558.86 |
Total Medicare Payment Amount |
95466.17 |
Total Medicare Standardized Payment Amount |
101642.13 |
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 |
21 |
Number Of Medical Services |
1708 |
Number Of Medicare Beneficiaries With Medical Services |
394 |
Total Medical Submitted Charge Amount |
235453.5 |
Total Medical Medicare Allowed Amount |
131558.86 |
Total Medical Medicare Payment Amount |
95466.17 |
Total Medical Medicare Standardized Payment Amount |
101642.13 |
Average Age Of Beneficiaries |
56 |
Number Of Beneficiaries Age Less65 |
266 |
Number Of Beneficiaries Age 65 to 74 |
70 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
219 |
Number Of Male Beneficiaries |
175 |
Number Of Non Hispanic White Beneficiaries |
363 |
Number Of Black or African American Beneficiaries |
14 |
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 |
176 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
218 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
38 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2668 |