National Provider Identifier [NPI]: |
1437347879 |
Last Name Of The Provider |
NATANAUAN |
First Name Of The Provider |
JANUARIO |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1215 N ALPINE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCKFORD |
Zip Code Of The Provider |
611072201 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
510 |
Number Of Medicare Beneficiaries |
358 |
Total Submitted Charge Amount |
49628 |
Total Medicare Allowed Amount |
27299.47 |
Total Medicare Payment Amount |
19079.98 |
Total Medicare Standardized Payment Amount |
18729.97 |
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 |
16 |
Number Of Medical Services |
510 |
Number Of Medicare Beneficiaries With Medical Services |
358 |
Total Medical Submitted Charge Amount |
49628 |
Total Medical Medicare Allowed Amount |
27299.47 |
Total Medical Medicare Payment Amount |
19079.98 |
Total Medical Medicare Standardized Payment Amount |
18729.97 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
142 |
Number Of Beneficiaries Age 75 to 84 |
115 |
Number Of Beneficiaries Age Greater 84 |
89 |
Number Of Female Beneficiaries |
220 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
155 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
159 |
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 |
346 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0054 |