| National Provider Identifier [NPI]: | 1689663627 |
| Last Name Of The Provider | PILAKOWSKI |
| First Name Of The Provider | CLEVE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5100 BOB BILLINGS PKWY |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | LAWRENCE |
| Zip Code Of The Provider | 660493998 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 4553 |
| Number Of Medicare Beneficiaries | 1408 |
| Total Submitted Charge Amount | 379758 |
| Total Medicare Allowed Amount | 250458.2 |
| Total Medicare Payment Amount | 175432.56 |
| Total Medicare Standardized Payment Amount | 189404.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 65 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 650 |
| Total Drug Medicare AllowedAmount | 370.7 |
| Total Drug Medicare PaymentAmount | 272.51 |
| Total Drug Medicare Standardized Payment Amount | 272.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 4488 |
| Number Of Medicare Beneficiaries With Medical Services | 1408 |
| Total Medical Submitted Charge Amount | 379108 |
| Total Medical Medicare Allowed Amount | 250087.5 |
| Total Medical Medicare Payment Amount | 175160.05 |
| Total Medical Medicare Standardized Payment Amount | 189132.21 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 146 |
| Number Of Beneficiaries Age 65 to 74 | 358 |
| Number Of Beneficiaries Age 75 to 84 | 445 |
| Number Of Beneficiaries Age Greater 84 | 459 |
| Number Of Female Beneficiaries | 878 |
| Number Of Male Beneficiaries | 530 |
| Number Of Non Hispanic White Beneficiaries | 1302 |
| Number Of Black or African American Beneficiaries | 42 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1002 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 406 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3651 |