National Provider Identifier [NPI]: |
1295963445 |
Last Name Of The Provider |
OJEDA |
First Name Of The Provider |
JASON |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
833 CHESTNUT STREET |
Street Address 2 Of The Provider |
SUITE 701 |
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191074409 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
511 |
Number Of Medicare Beneficiaries |
241 |
Total Submitted Charge Amount |
56265 |
Total Medicare Allowed Amount |
30328.35 |
Total Medicare Payment Amount |
22956.64 |
Total Medicare Standardized Payment Amount |
21809.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
67 |
Number Of Medicare Beneficiaries With Drug Services |
59 |
Total Drug Submitted ChargeAmount |
6670 |
Total Drug Medicare AllowedAmount |
2127.14 |
Total Drug Medicare PaymentAmount |
2077.41 |
Total Drug Medicare Standardized Payment Amount |
2077.41 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
444 |
Number Of Medicare Beneficiaries With Medical Services |
240 |
Total Medical Submitted Charge Amount |
49595 |
Total Medical Medicare Allowed Amount |
28201.21 |
Total Medical Medicare Payment Amount |
20879.23 |
Total Medical Medicare Standardized Payment Amount |
19732.18 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
99 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
126 |
Number Of Male Beneficiaries |
115 |
Number Of Non Hispanic White Beneficiaries |
118 |
Number Of Black or African American Beneficiaries |
105 |
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 |
168 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
73 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4918 |