| National Provider Identifier [NPI]: | 1093894016 |
| Last Name Of The Provider | JASAN |
| First Name Of The Provider | MARILEE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 311 MILLER AVE |
| Street Address 2 Of The Provider | SUITE I |
| City Of The Provider | MILL VALLEY |
| Zip Code Of The Provider | 949412844 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 834 |
| Number Of Medicare Beneficiaries | 203 |
| Total Submitted Charge Amount | 82254 |
| Total Medicare Allowed Amount | 75104.17 |
| Total Medicare Payment Amount | 54892.26 |
| Total Medicare Standardized Payment Amount | 49595.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 244 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 4273 |
| Total Drug Medicare AllowedAmount | 3541.58 |
| Total Drug Medicare PaymentAmount | 2740.91 |
| Total Drug Medicare Standardized Payment Amount | 2740.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 590 |
| Number Of Medicare Beneficiaries With Medical Services | 203 |
| Total Medical Submitted Charge Amount | 77981 |
| Total Medical Medicare Allowed Amount | 71562.59 |
| Total Medical Medicare Payment Amount | 52151.35 |
| Total Medical Medicare Standardized Payment Amount | 46855 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 121 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 146 |
| Number Of Male Beneficiaries | 57 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 10 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 38 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7057 |