National Provider Identifier [NPI]: |
1417048554 |
Last Name Of The Provider |
JORDAN |
First Name Of The Provider |
JACOB |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2335 TAMIAMI TRAIL N. |
Street Address 2 Of The Provider |
SUITE 501 |
City Of The Provider |
NAPLES |
Zip Code Of The Provider |
341034456 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
138 |
Number Of Services |
1812 |
Number Of Medicare Beneficiaries |
740 |
Total Submitted Charge Amount |
1940768.31 |
Total Medicare Allowed Amount |
624002.27 |
Total Medicare Payment Amount |
480325.66 |
Total Medicare Standardized Payment Amount |
441695.58 |
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 |
138 |
Number Of Medical Services |
1812 |
Number Of Medicare Beneficiaries With Medical Services |
740 |
Total Medical Submitted Charge Amount |
1940768.31 |
Total Medical Medicare Allowed Amount |
624002.27 |
Total Medical Medicare Payment Amount |
480325.66 |
Total Medical Medicare Standardized Payment Amount |
441695.58 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
335 |
Number Of Beneficiaries Age 75 to 84 |
286 |
Number Of Beneficiaries Age Greater 84 |
90 |
Number Of Female Beneficiaries |
392 |
Number Of Male Beneficiaries |
348 |
Number Of Non Hispanic White Beneficiaries |
692 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
706 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
30 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3563 |