| National Provider Identifier [NPI]: | 1336382373 |
| Last Name Of The Provider | AFFONSO |
| First Name Of The Provider | JESSE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10753 FALLS RD |
| Street Address 2 Of The Provider | SUITE 215 |
| City Of The Provider | LUTHERVILLE |
| Zip Code Of The Provider | 210934535 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 2208 |
| Number Of Medicare Beneficiaries | 518 |
| Total Submitted Charge Amount | 957477 |
| Total Medicare Allowed Amount | 277903.53 |
| Total Medicare Payment Amount | 212420.43 |
| Total Medicare Standardized Payment Amount | 208767.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 333 |
| Number Of Medicare Beneficiaries With Drug Services | 151 |
| Total Drug Submitted ChargeAmount | 9951 |
| Total Drug Medicare AllowedAmount | 4777.51 |
| Total Drug Medicare PaymentAmount | 3658.16 |
| Total Drug Medicare Standardized Payment Amount | 3658.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 1875 |
| Number Of Medicare Beneficiaries With Medical Services | 518 |
| Total Medical Submitted Charge Amount | 947526 |
| Total Medical Medicare Allowed Amount | 273126.02 |
| Total Medical Medicare Payment Amount | 208762.27 |
| Total Medical Medicare Standardized Payment Amount | 205109.26 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 73 |
| Number Of Beneficiaries Age 65 to 74 | 192 |
| Number Of Beneficiaries Age 75 to 84 | 153 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 323 |
| Number Of Male Beneficiaries | 195 |
| Number Of Non Hispanic White Beneficiaries | 500 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 415 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 103 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2648 |