| National Provider Identifier [NPI]: | 1558415414 |
| Last Name Of The Provider | JEROME |
| First Name Of The Provider | MARILYN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5215 LOUGHBORO RD NW |
| Street Address 2 Of The Provider | SUITE 500 |
| City Of The Provider | WASHINGTON |
| Zip Code Of The Provider | 200162618 |
| State Code Of The Provider | DC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Obstetrics/Gynecology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 1515 |
| Number Of Medicare Beneficiaries | 471 |
| Total Submitted Charge Amount | 73856.63 |
| Total Medicare Allowed Amount | 63492.27 |
| Total Medicare Payment Amount | 52249.42 |
| Total Medicare Standardized Payment Amount | 48642.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 543 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 8144.4 |
| Total Drug Medicare AllowedAmount | 7416.72 |
| Total Drug Medicare PaymentAmount | 5728.52 |
| Total Drug Medicare Standardized Payment Amount | 5728.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 972 |
| Number Of Medicare Beneficiaries With Medical Services | 471 |
| Total Medical Submitted Charge Amount | 65712.23 |
| Total Medical Medicare Allowed Amount | 56075.55 |
| Total Medical Medicare Payment Amount | 46520.9 |
| Total Medical Medicare Standardized Payment Amount | 42913.91 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 290 |
| Number Of Beneficiaries Age 75 to 84 | 153 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 471 |
| Number Of Male Beneficiaries | 0 |
| Number Of Non Hispanic White Beneficiaries | 433 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 4 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 3 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 5 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 36 |
| Percent Of With Ischemic Heart Disease | 11 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.5907 |