National Provider Identifier [NPI]: |
1902876782 |
Last Name Of The Provider |
JORDEN |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
401 E CHESTNUT ST |
Street Address 2 Of The Provider |
SUITE 710 |
City Of The Provider |
LOUISVILLE |
Zip Code Of The Provider |
402025700 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
119 |
Number Of Services |
948 |
Number Of Medicare Beneficiaries |
318 |
Total Submitted Charge Amount |
594518.25 |
Total Medicare Allowed Amount |
197261.96 |
Total Medicare Payment Amount |
149804.54 |
Total Medicare Standardized Payment Amount |
164112 |
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 |
119 |
Number Of Medical Services |
948 |
Number Of Medicare Beneficiaries With Medical Services |
318 |
Total Medical Submitted Charge Amount |
594518.25 |
Total Medical Medicare Allowed Amount |
197261.96 |
Total Medical Medicare Payment Amount |
149804.54 |
Total Medical Medicare Standardized Payment Amount |
164112 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
97 |
Number Of Beneficiaries Age 65 to 74 |
132 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
194 |
Number Of Male Beneficiaries |
124 |
Number Of Non Hispanic White Beneficiaries |
269 |
Number Of Black or African American Beneficiaries |
37 |
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 |
226 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
33 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5996 |