| National Provider Identifier [NPI]: | 1922110766 |
| Last Name Of The Provider | JORDAN |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 MIFFLIN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SCRANTON |
| Zip Code Of The Provider | 18503 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 5665 |
| Number Of Medicare Beneficiaries | 1993 |
| Total Submitted Charge Amount | 2414590 |
| Total Medicare Allowed Amount | 783603.39 |
| Total Medicare Payment Amount | 572221.38 |
| Total Medicare Standardized Payment Amount | 600439.92 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
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| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 216 |
| Number Of Beneficiaries Age 65 to 74 | 762 |
| Number Of Beneficiaries Age 75 to 84 | 695 |
| Number Of Beneficiaries Age Greater 84 | 320 |
| Number Of Female Beneficiaries | 1150 |
| Number Of Male Beneficiaries | 843 |
| Number Of Non Hispanic White Beneficiaries | 1888 |
| Number Of Black or African American Beneficiaries | 30 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1594 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 399 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.175 |