| National Provider Identifier [NPI]: | 1720060791 |
| Last Name Of The Provider | JORDAN |
| First Name Of The Provider | JOHN |
| 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 | 4101 TORRANCE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TORRANCE |
| Zip Code Of The Provider | 90503 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 182 |
| Number Of Services | 6772 |
| Number Of Medicare Beneficiaries | 2097 |
| Total Submitted Charge Amount | 1876003.25 |
| Total Medicare Allowed Amount | 260492.3 |
| Total Medicare Payment Amount | 193759.79 |
| Total Medicare Standardized Payment Amount | 179842.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3081 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 1098.77 |
| Total Drug Medicare AllowedAmount | 597.57 |
| Total Drug Medicare PaymentAmount | 468.52 |
| Total Drug Medicare Standardized Payment Amount | 468.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 179 |
| Number Of Medical Services | 3691 |
| Number Of Medicare Beneficiaries With Medical Services | 2096 |
| Total Medical Submitted Charge Amount | 1874904.48 |
| Total Medical Medicare Allowed Amount | 259894.73 |
| Total Medical Medicare Payment Amount | 193291.27 |
| Total Medical Medicare Standardized Payment Amount | 179374.34 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 265 |
| Number Of Beneficiaries Age 65 to 74 | 615 |
| Number Of Beneficiaries Age 75 to 84 | 691 |
| Number Of Beneficiaries Age Greater 84 | 526 |
| Number Of Female Beneficiaries | 1280 |
| Number Of Male Beneficiaries | 817 |
| Number Of Non Hispanic White Beneficiaries | 1068 |
| Number Of Black or African American Beneficiaries | 274 |
| Number Of AsianPacific Islander Beneficiaries | 367 |
| Number Of Hispanic Beneficiaries | 330 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1306 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 791 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.0204 |