| National Provider Identifier [NPI]: | 1447211941 |
| Last Name Of The Provider | JORDAN |
| First Name Of The Provider | KAREN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 311 E 89TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MERRILLVILLE |
| Zip Code Of The Provider | 464108126 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 7937 |
| Number Of Medicare Beneficiaries | 1291 |
| Total Submitted Charge Amount | 4953715.96 |
| Total Medicare Allowed Amount | 1367821.49 |
| Total Medicare Payment Amount | 1031693.33 |
| Total Medicare Standardized Payment Amount | 1101603.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 344 |
| Number Of Medicare Beneficiaries With Drug Services | 163 |
| Total Drug Submitted ChargeAmount | 222092.9 |
| Total Drug Medicare AllowedAmount | 78584.83 |
| Total Drug Medicare PaymentAmount | 60969.2 |
| Total Drug Medicare Standardized Payment Amount | 60969.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 7593 |
| Number Of Medicare Beneficiaries With Medical Services | 1291 |
| Total Medical Submitted Charge Amount | 4731623.06 |
| Total Medical Medicare Allowed Amount | 1289236.66 |
| Total Medical Medicare Payment Amount | 970724.13 |
| Total Medical Medicare Standardized Payment Amount | 1040634.31 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 594 |
| Number Of Beneficiaries Age 75 to 84 | 426 |
| Number Of Beneficiaries Age Greater 84 | 199 |
| Number Of Female Beneficiaries | 757 |
| Number Of Male Beneficiaries | 534 |
| Number Of Non Hispanic White Beneficiaries | 1182 |
| Number Of Black or African American Beneficiaries | 65 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1226 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 65 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| 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 | 12 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1017 |