| National Provider Identifier [NPI]: | 1023151685 |
| Last Name Of The Provider | PARK |
| First Name Of The Provider | DAN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3231 S NATIONAL AVE |
| Street Address 2 Of The Provider | SUITE 160 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 658077304 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 4138 |
| Number Of Medicare Beneficiaries | 643 |
| Total Submitted Charge Amount | 744958.9 |
| Total Medicare Allowed Amount | 293021.97 |
| Total Medicare Payment Amount | 218882.95 |
| Total Medicare Standardized Payment Amount | 236084.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1419 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 62504 |
| Total Drug Medicare AllowedAmount | 39000.38 |
| Total Drug Medicare PaymentAmount | 30539.98 |
| Total Drug Medicare Standardized Payment Amount | 30539.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 2719 |
| Number Of Medicare Beneficiaries With Medical Services | 643 |
| Total Medical Submitted Charge Amount | 682454.9 |
| Total Medical Medicare Allowed Amount | 254021.59 |
| Total Medical Medicare Payment Amount | 188342.97 |
| Total Medical Medicare Standardized Payment Amount | 205544.5 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 141 |
| Number Of Beneficiaries Age 65 to 74 | 277 |
| Number Of Beneficiaries Age 75 to 84 | 167 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 382 |
| Number Of Male Beneficiaries | 261 |
| Number Of Non Hispanic White Beneficiaries | 621 |
| 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 | 507 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 136 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.5184 |