National Provider Identifier [NPI]: |
1255403267 |
Last Name Of The Provider |
CORDELL |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9850 GENESEE AVENUE |
Street Address 2 Of The Provider |
SUITE 430 |
City Of The Provider |
LA JOLLA |
Zip Code Of The Provider |
92037 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
851 |
Number Of Medicare Beneficiaries |
259 |
Total Submitted Charge Amount |
76978 |
Total Medicare Allowed Amount |
62610.58 |
Total Medicare Payment Amount |
40141.27 |
Total Medicare Standardized Payment Amount |
39533.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
71 |
Number Of Medicare Beneficiaries With Drug Services |
69 |
Total Drug Submitted ChargeAmount |
1785 |
Total Drug Medicare AllowedAmount |
843.46 |
Total Drug Medicare PaymentAmount |
826.52 |
Total Drug Medicare Standardized Payment Amount |
826.52 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
780 |
Number Of Medicare Beneficiaries With Medical Services |
258 |
Total Medical Submitted Charge Amount |
75193 |
Total Medical Medicare Allowed Amount |
61767.12 |
Total Medical Medicare Payment Amount |
39314.75 |
Total Medical Medicare Standardized Payment Amount |
38706.76 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
107 |
Number Of Beneficiaries Age 75 to 84 |
90 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
109 |
Number Of Male Beneficiaries |
150 |
Number Of Non Hispanic White Beneficiaries |
222 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
12 |
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
|
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9397 |