| National Provider Identifier [NPI]: | 1841266806 |
| Last Name Of The Provider | JONES |
| First Name Of The Provider | MARC |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1221 PINE GROVE AVE |
| Street Address 2 Of The Provider | MCLAREN PORT HURON - EMERGENCY MEDICINE DEPARTMENT |
| City Of The Provider | PORT HURON |
| Zip Code Of The Provider | 480603511 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 1882 |
| Number Of Medicare Beneficiaries | 973 |
| Total Submitted Charge Amount | 324939 |
| Total Medicare Allowed Amount | 176429.04 |
| Total Medicare Payment Amount | 136473.47 |
| Total Medicare Standardized Payment Amount | 138607 |
| 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 | 35 |
| Number Of Medical Services | 1882 |
| Number Of Medicare Beneficiaries With Medical Services | 973 |
| Total Medical Submitted Charge Amount | 324939 |
| Total Medical Medicare Allowed Amount | 176429.04 |
| Total Medical Medicare Payment Amount | 136473.47 |
| Total Medical Medicare Standardized Payment Amount | 138607 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 256 |
| Number Of Beneficiaries Age 65 to 74 | 270 |
| Number Of Beneficiaries Age 75 to 84 | 252 |
| Number Of Beneficiaries Age Greater 84 | 195 |
| Number Of Female Beneficiaries | 532 |
| Number Of Male Beneficiaries | 441 |
| Number Of Non Hispanic White Beneficiaries | 902 |
| Number Of Black or African American Beneficiaries | 35 |
| 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 | 640 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 333 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 44 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.9672 |