| National Provider Identifier [NPI]: | 1952563066 |
| Last Name Of The Provider | JEFFRIES |
| First Name Of The Provider | JUSTIN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | HC 70 BOX 16 |
| Street Address 2 Of The Provider | |
| City Of The Provider | WHITE SULPHUR SPRINGS |
| Zip Code Of The Provider | 249869603 |
| State Code Of The Provider | WV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 4396 |
| Number Of Medicare Beneficiaries | 152 |
| Total Submitted Charge Amount | 262680 |
| Total Medicare Allowed Amount | 93550.33 |
| Total Medicare Payment Amount | 67395.83 |
| Total Medicare Standardized Payment Amount | 71377.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 30 |
| Number Of Drug Services | 3552 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 113099 |
| Total Drug Medicare AllowedAmount | 34812.46 |
| Total Drug Medicare PaymentAmount | 27268.97 |
| Total Drug Medicare Standardized Payment Amount | 27268.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 844 |
| Number Of Medicare Beneficiaries With Medical Services | 152 |
| Total Medical Submitted Charge Amount | 149581 |
| Total Medical Medicare Allowed Amount | 58737.87 |
| Total Medical Medicare Payment Amount | 40126.86 |
| Total Medical Medicare Standardized Payment Amount | 44108.99 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 54 |
| Number Of Beneficiaries Age 75 to 84 | 27 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 93 |
| Number Of Male Beneficiaries | 59 |
| Number Of Non Hispanic White Beneficiaries | 139 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 96 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1958 |