| National Provider Identifier [NPI]: | 1659326544 |
| Last Name Of The Provider | TRIPP |
| First Name Of The Provider | JACKIE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5130 LINTON BLVD |
| Street Address 2 Of The Provider | SUITE C1 |
| City Of The Provider | DELRAY BEACH |
| Zip Code Of The Provider | 334846595 |
| 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 | 55 |
| Number Of Services | 26731 |
| Number Of Medicare Beneficiaries | 2158 |
| Total Submitted Charge Amount | 1732120.94 |
| Total Medicare Allowed Amount | 1330090.76 |
| Total Medicare Payment Amount | 1000713.71 |
| Total Medicare Standardized Payment Amount | 884850.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 168 |
| Number Of Medicare Beneficiaries With Drug Services | 115 |
| Total Drug Submitted ChargeAmount | 5012.66 |
| Total Drug Medicare AllowedAmount | 4520.55 |
| Total Drug Medicare PaymentAmount | 3426.05 |
| Total Drug Medicare Standardized Payment Amount | 3426.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 26563 |
| Number Of Medicare Beneficiaries With Medical Services | 2158 |
| Total Medical Submitted Charge Amount | 1727108.28 |
| Total Medical Medicare Allowed Amount | 1325570.21 |
| Total Medical Medicare Payment Amount | 997287.66 |
| Total Medical Medicare Standardized Payment Amount | 881424.74 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 650 |
| Number Of Beneficiaries Age 75 to 84 | 903 |
| Number Of Beneficiaries Age Greater 84 | 572 |
| Number Of Female Beneficiaries | 1111 |
| Number Of Male Beneficiaries | 1047 |
| Number Of Non Hispanic White Beneficiaries | 2109 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2107 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.36 |