National Provider Identifier [NPI]: |
1861473076 |
Last Name Of The Provider |
MCMANUS |
First Name Of The Provider |
DENNIS |
Middle Initial Of The Provider |
Q |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8600 N IL-91 |
Street Address 2 Of The Provider |
SUITE 110 |
City Of The Provider |
PEORIA |
Zip Code Of The Provider |
61615 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Geriatric Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
412 |
Number Of Medicare Beneficiaries |
164 |
Total Submitted Charge Amount |
123128 |
Total Medicare Allowed Amount |
34097.24 |
Total Medicare Payment Amount |
24981.44 |
Total Medicare Standardized Payment Amount |
25087.8 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
78 |
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
21 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
106 |
Number Of Male Beneficiaries |
58 |
Number Of Non Hispanic White Beneficiaries |
150 |
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 |
108 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
62 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5983 |