| National Provider Identifier [NPI]: | 1760598148 |
| Last Name Of The Provider | ELLMAN |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2850 TELEGRAPH AVE |
| Street Address 2 Of The Provider | SUITE 120 |
| City Of The Provider | BERKELEY |
| Zip Code Of The Provider | 947051192 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 3933 |
| Number Of Medicare Beneficiaries | 247 |
| Total Submitted Charge Amount | 455610 |
| Total Medicare Allowed Amount | 190378.97 |
| Total Medicare Payment Amount | 142136.74 |
| Total Medicare Standardized Payment Amount | 136430.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 3239 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 263223 |
| Total Drug Medicare AllowedAmount | 126392.13 |
| Total Drug Medicare PaymentAmount | 98376.27 |
| Total Drug Medicare Standardized Payment Amount | 98376.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 694 |
| Number Of Medicare Beneficiaries With Medical Services | 247 |
| Total Medical Submitted Charge Amount | 192387 |
| Total Medical Medicare Allowed Amount | 63986.84 |
| Total Medical Medicare Payment Amount | 43760.47 |
| Total Medical Medicare Standardized Payment Amount | 38054.7 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 113 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 184 |
| Number Of Male Beneficiaries | 63 |
| Number Of Non Hispanic White Beneficiaries | 162 |
| Number Of Black or African American Beneficiaries | 38 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| 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 | 198 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 14 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1079 |