| National Provider Identifier [NPI]: | 1194821850 |
| Last Name Of The Provider | JORDAN |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1285 UPPER HEMBREE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROSWELL |
| Zip Code Of The Provider | 300761143 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 4217 |
| Number Of Medicare Beneficiaries | 1448 |
| Total Submitted Charge Amount | 998997 |
| Total Medicare Allowed Amount | 324573.04 |
| Total Medicare Payment Amount | 246296.85 |
| Total Medicare Standardized Payment Amount | 245809.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 329 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 26126 |
| Total Drug Medicare AllowedAmount | 12890.27 |
| Total Drug Medicare PaymentAmount | 10106.08 |
| Total Drug Medicare Standardized Payment Amount | 10106.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 3888 |
| Number Of Medicare Beneficiaries With Medical Services | 1447 |
| Total Medical Submitted Charge Amount | 972871 |
| Total Medical Medicare Allowed Amount | 311682.77 |
| Total Medical Medicare Payment Amount | 236190.77 |
| Total Medical Medicare Standardized Payment Amount | 235703.47 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 107 |
| Number Of Beneficiaries Age 65 to 74 | 501 |
| Number Of Beneficiaries Age 75 to 84 | 504 |
| Number Of Beneficiaries Age Greater 84 | 336 |
| Number Of Female Beneficiaries | 766 |
| Number Of Male Beneficiaries | 682 |
| Number Of Non Hispanic White Beneficiaries | 1341 |
| Number Of Black or African American Beneficiaries | 58 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1267 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 181 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.5982 |