| National Provider Identifier [NPI]: | 1306021076 |
| Last Name Of The Provider | ANGELL |
| First Name Of The Provider | JORDAN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 410 MALCOLM DR |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | WESTMINSTER |
| Zip Code Of The Provider | 211576160 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 4948 |
| Number Of Medicare Beneficiaries | 676 |
| Total Submitted Charge Amount | 480270.5 |
| Total Medicare Allowed Amount | 238904.19 |
| Total Medicare Payment Amount | 177970.23 |
| Total Medicare Standardized Payment Amount | 171423.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1710 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 42657 |
| Total Drug Medicare AllowedAmount | 23310.48 |
| Total Drug Medicare PaymentAmount | 17727.08 |
| Total Drug Medicare Standardized Payment Amount | 17727.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 3238 |
| Number Of Medicare Beneficiaries With Medical Services | 676 |
| Total Medical Submitted Charge Amount | 437613.5 |
| Total Medical Medicare Allowed Amount | 215593.71 |
| Total Medical Medicare Payment Amount | 160243.15 |
| Total Medical Medicare Standardized Payment Amount | 153696.39 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 292 |
| Number Of Beneficiaries Age 75 to 84 | 216 |
| Number Of Beneficiaries Age Greater 84 | 115 |
| Number Of Female Beneficiaries | 236 |
| Number Of Male Beneficiaries | 440 |
| Number Of Non Hispanic White Beneficiaries | 633 |
| Number Of Black or African American Beneficiaries | 27 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 606 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3212 |