| National Provider Identifier [NPI]: | 1659391084 |
| Last Name Of The Provider | FALLIS |
| First Name Of The Provider | JONATHON |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1513 UNION AVE |
| Street Address 2 Of The Provider | SUITE 1400 |
| City Of The Provider | MOBERLY |
| Zip Code Of The Provider | 65270 |
| 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 | 34 |
| Number Of Services | 3768 |
| Number Of Medicare Beneficiaries | 1442 |
| Total Submitted Charge Amount | 229753 |
| Total Medicare Allowed Amount | 170593.88 |
| Total Medicare Payment Amount | 118890.04 |
| Total Medicare Standardized Payment Amount | 130181.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 23 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 230 |
| Total Drug Medicare AllowedAmount | 68.75 |
| Total Drug Medicare PaymentAmount | 53.91 |
| Total Drug Medicare Standardized Payment Amount | 53.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 3745 |
| Number Of Medicare Beneficiaries With Medical Services | 1442 |
| Total Medical Submitted Charge Amount | 229523 |
| Total Medical Medicare Allowed Amount | 170525.13 |
| Total Medical Medicare Payment Amount | 118836.13 |
| Total Medical Medicare Standardized Payment Amount | 130128.02 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 209 |
| Number Of Beneficiaries Age 65 to 74 | 275 |
| Number Of Beneficiaries Age 75 to 84 | 405 |
| Number Of Beneficiaries Age Greater 84 | 553 |
| Number Of Female Beneficiaries | 940 |
| Number Of Male Beneficiaries | 502 |
| Number Of Non Hispanic White Beneficiaries | 1354 |
| Number Of Black or African American Beneficiaries | 67 |
| 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 | 747 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 695 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 50 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 18 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6432 |