| National Provider Identifier [NPI]: | 1841269651 |
| Last Name Of The Provider | FONDA |
| First Name Of The Provider | JELLES |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5601 LOCH RAVEN BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212392905 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 5184 |
| Number Of Medicare Beneficiaries | 1873 |
| Total Submitted Charge Amount | 709200 |
| Total Medicare Allowed Amount | 314548.34 |
| Total Medicare Payment Amount | 239932.53 |
| Total Medicare Standardized Payment Amount | 228783.53 |
| 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 | 44 |
| Number Of Medical Services | 5184 |
| Number Of Medicare Beneficiaries With Medical Services | 1873 |
| Total Medical Submitted Charge Amount | 709200 |
| Total Medical Medicare Allowed Amount | 314548.34 |
| Total Medical Medicare Payment Amount | 239932.53 |
| Total Medical Medicare Standardized Payment Amount | 228783.53 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 452 |
| Number Of Beneficiaries Age 65 to 74 | 565 |
| Number Of Beneficiaries Age 75 to 84 | 499 |
| Number Of Beneficiaries Age Greater 84 | 357 |
| Number Of Female Beneficiaries | 1087 |
| Number Of Male Beneficiaries | 786 |
| Number Of Non Hispanic White Beneficiaries | 715 |
| Number Of Black or African American Beneficiaries | 1117 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1220 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 653 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 55 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.977 |