| National Provider Identifier [NPI]: | 1659339414 |
| Last Name Of The Provider | WALDMAN |
| First Name Of The Provider | JERALD |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 26401 CROWN VALLEY PKWY |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | MISSION VIEJO |
| Zip Code Of The Provider | 926916302 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 106 |
| Number Of Services | 1237 |
| Number Of Medicare Beneficiaries | 223 |
| Total Submitted Charge Amount | 471071.01 |
| Total Medicare Allowed Amount | 158966.23 |
| Total Medicare Payment Amount | 120720.98 |
| Total Medicare Standardized Payment Amount | 107942.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 99 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 13750 |
| Total Drug Medicare AllowedAmount | 6848.05 |
| Total Drug Medicare PaymentAmount | 5368.83 |
| Total Drug Medicare Standardized Payment Amount | 5368.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 103 |
| Number Of Medical Services | 1138 |
| Number Of Medicare Beneficiaries With Medical Services | 223 |
| Total Medical Submitted Charge Amount | 457321.01 |
| Total Medical Medicare Allowed Amount | 152118.18 |
| Total Medical Medicare Payment Amount | 115352.15 |
| Total Medical Medicare Standardized Payment Amount | 102574.06 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 93 |
| Number Of Beneficiaries Age 75 to 84 | 87 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 128 |
| Number Of Male Beneficiaries | 95 |
| Number Of Non Hispanic White Beneficiaries | 195 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 204 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0897 |