| National Provider Identifier [NPI]: | 1760473466 |
| Last Name Of The Provider | JORGENSEN |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5605 W EUGIE AVE |
| Street Address 2 Of The Provider | #200 |
| City Of The Provider | GLENDALE |
| Zip Code Of The Provider | 853041272 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 26865 |
| Number Of Medicare Beneficiaries | 507 |
| Total Submitted Charge Amount | 775933 |
| Total Medicare Allowed Amount | 336923.97 |
| Total Medicare Payment Amount | 253770.71 |
| Total Medicare Standardized Payment Amount | 255568.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 101 |
| Number Of Medicare Beneficiaries With Drug Services | 68 |
| Total Drug Submitted ChargeAmount | 2520 |
| Total Drug Medicare AllowedAmount | 574.56 |
| Total Drug Medicare PaymentAmount | 556.67 |
| Total Drug Medicare Standardized Payment Amount | 556.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 26764 |
| Number Of Medicare Beneficiaries With Medical Services | 506 |
| Total Medical Submitted Charge Amount | 773413 |
| Total Medical Medicare Allowed Amount | 336349.41 |
| Total Medical Medicare Payment Amount | 253214.04 |
| Total Medical Medicare Standardized Payment Amount | 255011.86 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 334 |
| Number Of Beneficiaries Age 75 to 84 | 113 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 342 |
| Number Of Male Beneficiaries | 165 |
| Number Of Non Hispanic White Beneficiaries | 459 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 487 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 50 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8871 |