| National Provider Identifier [NPI]: | 1023083870 |
| Last Name Of The Provider | QUAYLE |
| First Name Of The Provider | MANX |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1626 30TH AVE STE 202 |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | FAIRBANKS |
| Zip Code Of The Provider | 997017423 |
| State Code Of The Provider | AK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 528 |
| Number Of Medicare Beneficiaries | 155 |
| Total Submitted Charge Amount | 194559 |
| Total Medicare Allowed Amount | 50558.99 |
| Total Medicare Payment Amount | 36748.03 |
| Total Medicare Standardized Payment Amount | 30042.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 50 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 1772 |
| Total Drug Medicare AllowedAmount | 437.2 |
| Total Drug Medicare PaymentAmount | 342.78 |
| Total Drug Medicare Standardized Payment Amount | 342.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 478 |
| Number Of Medicare Beneficiaries With Medical Services | 155 |
| Total Medical Submitted Charge Amount | 192787 |
| Total Medical Medicare Allowed Amount | 50121.79 |
| Total Medical Medicare Payment Amount | 36405.25 |
| Total Medical Medicare Standardized Payment Amount | 29700.02 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 72 |
| Number Of Beneficiaries Age 75 to 84 | 47 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 88 |
| Number Of Male Beneficiaries | 67 |
| Number Of Non Hispanic White Beneficiaries | 135 |
| 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 | 125 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3004 |