National Provider Identifier [NPI]: |
1144489592 |
Last Name Of The Provider |
NEWMARK |
First Name Of The Provider |
JORDAN |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
450 BROADWAY STREET |
Street Address 2 Of The Provider |
1ST FLOOR, PAV A |
City Of The Provider |
REDWOOD CITY |
Zip Code Of The Provider |
94063 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
90 |
Number Of Services |
620 |
Number Of Medicare Beneficiaries |
345 |
Total Submitted Charge Amount |
419702.4 |
Total Medicare Allowed Amount |
88521.66 |
Total Medicare Payment Amount |
67708.41 |
Total Medicare Standardized Payment Amount |
61263.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
90 |
Number Of Medical Services |
620 |
Number Of Medicare Beneficiaries With Medical Services |
345 |
Total Medical Submitted Charge Amount |
419702.4 |
Total Medical Medicare Allowed Amount |
88521.66 |
Total Medical Medicare Payment Amount |
67708.41 |
Total Medical Medicare Standardized Payment Amount |
61263.5 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
111 |
Number Of Beneficiaries Age 65 to 74 |
124 |
Number Of Beneficiaries Age 75 to 84 |
83 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
194 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
262 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
31 |
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
243 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
102 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.5892 |