| National Provider Identifier [NPI]: | 1760501373 |
| Last Name Of The Provider | HEIST |
| First Name Of The Provider | JON |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 361 N MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | GLASSBORO |
| Zip Code Of The Provider | 080281920 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 2646 |
| Number Of Medicare Beneficiaries | 406 |
| Total Submitted Charge Amount | 306615 |
| Total Medicare Allowed Amount | 197373.13 |
| Total Medicare Payment Amount | 139887.51 |
| Total Medicare Standardized Payment Amount | 137618.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 315 |
| Number Of Medicare Beneficiaries With Drug Services | 158 |
| Total Drug Submitted ChargeAmount | 6790 |
| Total Drug Medicare AllowedAmount | 3687.52 |
| Total Drug Medicare PaymentAmount | 3400.25 |
| Total Drug Medicare Standardized Payment Amount | 3400.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 2331 |
| Number Of Medicare Beneficiaries With Medical Services | 406 |
| Total Medical Submitted Charge Amount | 299825 |
| Total Medical Medicare Allowed Amount | 193685.61 |
| Total Medical Medicare Payment Amount | 136487.26 |
| Total Medical Medicare Standardized Payment Amount | 134218.39 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 83 |
| Number Of Beneficiaries Age 65 to 74 | 174 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 56 |
| Number Of Female Beneficiaries | 238 |
| Number Of Male Beneficiaries | 168 |
| Number Of Non Hispanic White Beneficiaries | 313 |
| Number Of Black or African American Beneficiaries | 74 |
| 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 | 346 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 60 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 71 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.1855 |