| National Provider Identifier [NPI]: | 1093761785 |
| Last Name Of The Provider | WHITE |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1240 BIG JACK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PLATTEVILLE |
| Zip Code Of The Provider | 538188902 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 123 |
| Number Of Services | 2954 |
| Number Of Medicare Beneficiaries | 493 |
| Total Submitted Charge Amount | 234496 |
| Total Medicare Allowed Amount | 131613.41 |
| Total Medicare Payment Amount | 93828.62 |
| Total Medicare Standardized Payment Amount | 97603.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 652 |
| Number Of Medicare Beneficiaries With Drug Services | 92 |
| Total Drug Submitted ChargeAmount | 6958.5 |
| Total Drug Medicare AllowedAmount | 3989.18 |
| Total Drug Medicare PaymentAmount | 3626.4 |
| Total Drug Medicare Standardized Payment Amount | 3626.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 112 |
| Number Of Medical Services | 2302 |
| Number Of Medicare Beneficiaries With Medical Services | 493 |
| Total Medical Submitted Charge Amount | 227537.5 |
| Total Medical Medicare Allowed Amount | 127624.23 |
| Total Medical Medicare Payment Amount | 90202.22 |
| Total Medical Medicare Standardized Payment Amount | 93977.44 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 136 |
| Number Of Beneficiaries Age 75 to 84 | 169 |
| Number Of Beneficiaries Age Greater 84 | 122 |
| Number Of Female Beneficiaries | 325 |
| Number Of Male Beneficiaries | 168 |
| 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 | 270 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 223 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0939 |