| National Provider Identifier [NPI]: | 1164462412 |
| Last Name Of The Provider | GIVENS |
| First Name Of The Provider | JERRY |
| 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 | 525 BRANSON LANDING BLVD |
| Street Address 2 Of The Provider | FERRELL DUNCAN CLINIC UROLOGY (SUITE 307) |
| City Of The Provider | BRANSON |
| Zip Code Of The Provider | 656164500 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 2456 |
| Number Of Medicare Beneficiaries | 489 |
| Total Submitted Charge Amount | 510711 |
| Total Medicare Allowed Amount | 201810.21 |
| Total Medicare Payment Amount | 151391.88 |
| Total Medicare Standardized Payment Amount | 163287.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 117 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 11643 |
| Total Drug Medicare AllowedAmount | 4424 |
| Total Drug Medicare PaymentAmount | 3366.76 |
| Total Drug Medicare Standardized Payment Amount | 3366.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 2339 |
| Number Of Medicare Beneficiaries With Medical Services | 489 |
| Total Medical Submitted Charge Amount | 499068 |
| Total Medical Medicare Allowed Amount | 197386.21 |
| Total Medical Medicare Payment Amount | 148025.12 |
| Total Medical Medicare Standardized Payment Amount | 159920.7 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 220 |
| Number Of Beneficiaries Age 75 to 84 | 163 |
| Number Of Beneficiaries Age Greater 84 | 61 |
| Number Of Female Beneficiaries | 117 |
| Number Of Male Beneficiaries | 372 |
| Number Of Non Hispanic White Beneficiaries | 477 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 431 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.6241 |