| National Provider Identifier [NPI]: | 1700851482 |
| Last Name Of The Provider | ANDREY |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10666 N TORREY PINES RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LA JOLLA |
| Zip Code Of The Provider | 920371027 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 62646 |
| Number Of Medicare Beneficiaries | 458 |
| Total Submitted Charge Amount | 1845990.01 |
| Total Medicare Allowed Amount | 703312.06 |
| Total Medicare Payment Amount | 538920.49 |
| Total Medicare Standardized Payment Amount | 534856.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 73 |
| Number Of Drug Services | 60889 |
| Number Of Medicare Beneficiaries With Drug Services | 157 |
| Total Drug Submitted ChargeAmount | 1528716 |
| Total Drug Medicare AllowedAmount | 564860.64 |
| Total Drug Medicare PaymentAmount | 437615.68 |
| Total Drug Medicare Standardized Payment Amount | 437615.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 1757 |
| Number Of Medicare Beneficiaries With Medical Services | 458 |
| Total Medical Submitted Charge Amount | 317274.01 |
| Total Medical Medicare Allowed Amount | 138451.42 |
| Total Medical Medicare Payment Amount | 101304.81 |
| Total Medical Medicare Standardized Payment Amount | 97240.99 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 230 |
| Number Of Beneficiaries Age 75 to 84 | 139 |
| Number Of Beneficiaries Age Greater 84 | 65 |
| Number Of Female Beneficiaries | 248 |
| Number Of Male Beneficiaries | 210 |
| Number Of Non Hispanic White Beneficiaries | 387 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 416 |
| 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 | 6 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.7847 |