National Provider Identifier [NPI]: |
1861476970 |
Last Name Of The Provider |
WHITING |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
310 W LOSEY ST |
Street Address 2 Of The Provider |
ORTHOPAEDIC CLINIC |
City Of The Provider |
SCOTT AFB |
Zip Code Of The Provider |
622255250 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
966 |
Number Of Medicare Beneficiaries |
399 |
Total Submitted Charge Amount |
409232.25 |
Total Medicare Allowed Amount |
172419.6 |
Total Medicare Payment Amount |
133412.42 |
Total Medicare Standardized Payment Amount |
133843.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
147 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
7924 |
Total Drug Medicare AllowedAmount |
1556.98 |
Total Drug Medicare PaymentAmount |
1220.76 |
Total Drug Medicare Standardized Payment Amount |
1220.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
63 |
Number Of Medical Services |
819 |
Number Of Medicare Beneficiaries With Medical Services |
399 |
Total Medical Submitted Charge Amount |
401308.25 |
Total Medical Medicare Allowed Amount |
170862.62 |
Total Medical Medicare Payment Amount |
132191.66 |
Total Medical Medicare Standardized Payment Amount |
132622.95 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
162 |
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
288 |
Number Of Male Beneficiaries |
111 |
Number Of Non Hispanic White Beneficiaries |
216 |
Number Of Black or African American Beneficiaries |
170 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
201 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
198 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.6527 |