National Provider Identifier [NPI]: |
1326067042 |
Last Name Of The Provider |
JONES |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DPM, |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1102 S ROSELLE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SCHAUMBURG |
Zip Code Of The Provider |
601934072 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
88 |
Number Of Services |
907 |
Number Of Medicare Beneficiaries |
331 |
Total Submitted Charge Amount |
179850 |
Total Medicare Allowed Amount |
82211.35 |
Total Medicare Payment Amount |
61636.48 |
Total Medicare Standardized Payment Amount |
65801.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
88 |
Number Of Medical Services |
907 |
Number Of Medicare Beneficiaries With Medical Services |
331 |
Total Medical Submitted Charge Amount |
179850 |
Total Medical Medicare Allowed Amount |
82211.35 |
Total Medical Medicare Payment Amount |
61636.48 |
Total Medical Medicare Standardized Payment Amount |
65801.83 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
121 |
Number Of Beneficiaries Age 75 to 84 |
82 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
198 |
Number Of Male Beneficiaries |
133 |
Number Of Non Hispanic White Beneficiaries |
161 |
Number Of Black or African American Beneficiaries |
137 |
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 |
222 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
109 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0942 |