| National Provider Identifier [NPI]: | 1548237837 |
| Last Name Of The Provider | SCHWARZ |
| First Name Of The Provider | JACALYN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2900 FRANK SCOTT PKWY W |
| Street Address 2 Of The Provider | SUITE 900 |
| City Of The Provider | BELLEVILLE |
| Zip Code Of The Provider | 622235000 |
| 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 | 18 |
| Number Of Services | 1715 |
| Number Of Medicare Beneficiaries | 442 |
| Total Submitted Charge Amount | 71496.72 |
| Total Medicare Allowed Amount | 65886.55 |
| Total Medicare Payment Amount | 46711.4 |
| Total Medicare Standardized Payment Amount | 47939.42 |
| 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 | 18 |
| Number Of Medical Services | 1715 |
| Number Of Medicare Beneficiaries With Medical Services | 442 |
| Total Medical Submitted Charge Amount | 71496.72 |
| Total Medical Medicare Allowed Amount | 65886.55 |
| Total Medical Medicare Payment Amount | 46711.4 |
| Total Medical Medicare Standardized Payment Amount | 47939.42 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 171 |
| Number Of Beneficiaries Age Greater 84 | 127 |
| Number Of Female Beneficiaries | 286 |
| Number Of Male Beneficiaries | 156 |
| Number Of Non Hispanic White Beneficiaries | 407 |
| 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 | 414 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5377 |