National Provider Identifier [NPI]: |
1609170513 |
Last Name Of The Provider |
JENKINS |
First Name Of The Provider |
LUKE |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
ONE HOAG DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEWPORT BEACH |
Zip Code Of The Provider |
926634162 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
586 |
Number Of Medicare Beneficiaries |
211 |
Total Submitted Charge Amount |
178400.84 |
Total Medicare Allowed Amount |
50546.06 |
Total Medicare Payment Amount |
39228.58 |
Total Medicare Standardized Payment Amount |
46740.28 |
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 |
49 |
Number Of Medical Services |
586 |
Number Of Medicare Beneficiaries With Medical Services |
211 |
Total Medical Submitted Charge Amount |
178400.84 |
Total Medical Medicare Allowed Amount |
50546.06 |
Total Medical Medicare Payment Amount |
39228.58 |
Total Medical Medicare Standardized Payment Amount |
46740.28 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
94 |
Number Of Male Beneficiaries |
117 |
Number Of Non Hispanic White Beneficiaries |
186 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
169 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
26 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.3936 |