National Provider Identifier [NPI]: |
1174502868 |
Last Name Of The Provider |
SIGLE |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2921 MONTVALE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627045359 |
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 |
92 |
Number Of Services |
2713 |
Number Of Medicare Beneficiaries |
532 |
Total Submitted Charge Amount |
454078 |
Total Medicare Allowed Amount |
227227.37 |
Total Medicare Payment Amount |
167514.41 |
Total Medicare Standardized Payment Amount |
177665.02 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
218 |
Number Of Medicare Beneficiaries With Drug Services |
68 |
Total Drug Submitted ChargeAmount |
9834 |
Total Drug Medicare AllowedAmount |
2216.02 |
Total Drug Medicare PaymentAmount |
1737.42 |
Total Drug Medicare Standardized Payment Amount |
1737.42 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
90 |
Number Of Medical Services |
2495 |
Number Of Medicare Beneficiaries With Medical Services |
532 |
Total Medical Submitted Charge Amount |
444244 |
Total Medical Medicare Allowed Amount |
225011.35 |
Total Medical Medicare Payment Amount |
165776.99 |
Total Medical Medicare Standardized Payment Amount |
175927.6 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
236 |
Number Of Beneficiaries Age 75 to 84 |
152 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
294 |
Number Of Male Beneficiaries |
238 |
Number Of Non Hispanic White Beneficiaries |
486 |
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 |
420 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
112 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
1.2957 |