| National Provider Identifier [NPI]: | 1285628982 |
| Last Name Of The Provider | JAFFE |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 35 TOWER CT |
| Street Address 2 Of The Provider | STE F |
| City Of The Provider | GURNEE |
| Zip Code Of The Provider | 600315712 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 7169 |
| Number Of Medicare Beneficiaries | 2301 |
| Total Submitted Charge Amount | 1238835 |
| Total Medicare Allowed Amount | 657490.39 |
| Total Medicare Payment Amount | 495080.11 |
| Total Medicare Standardized Payment Amount | 473223.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 455 |
| Number Of Medicare Beneficiaries With Drug Services | 113 |
| Total Drug Submitted ChargeAmount | 45500 |
| Total Drug Medicare AllowedAmount | 23330.55 |
| Total Drug Medicare PaymentAmount | 17845.46 |
| Total Drug Medicare Standardized Payment Amount | 17845.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 6714 |
| Number Of Medicare Beneficiaries With Medical Services | 2301 |
| Total Medical Submitted Charge Amount | 1193335 |
| Total Medical Medicare Allowed Amount | 634159.84 |
| Total Medical Medicare Payment Amount | 477234.65 |
| Total Medical Medicare Standardized Payment Amount | 455378.1 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 254 |
| Number Of Beneficiaries Age 65 to 74 | 740 |
| Number Of Beneficiaries Age 75 to 84 | 809 |
| Number Of Beneficiaries Age Greater 84 | 498 |
| Number Of Female Beneficiaries | 1237 |
| Number Of Male Beneficiaries | 1064 |
| Number Of Non Hispanic White Beneficiaries | 1853 |
| Number Of Black or African American Beneficiaries | 226 |
| Number Of AsianPacific Islander Beneficiaries | 40 |
| Number Of Hispanic Beneficiaries | 153 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1782 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 519 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.9169 |