National Provider Identifier [NPI]: |
1679650287 |
Last Name Of The Provider |
KAZMER |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
D.P.M. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4103 W 26TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606234313 |
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 |
40 |
Number Of Services |
556 |
Number Of Medicare Beneficiaries |
248 |
Total Submitted Charge Amount |
109274 |
Total Medicare Allowed Amount |
45103 |
Total Medicare Payment Amount |
33429.57 |
Total Medicare Standardized Payment Amount |
31819.49 |
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 |
40 |
Number Of Medical Services |
556 |
Number Of Medicare Beneficiaries With Medical Services |
248 |
Total Medical Submitted Charge Amount |
109274 |
Total Medical Medicare Allowed Amount |
45103 |
Total Medical Medicare Payment Amount |
33429.57 |
Total Medical Medicare Standardized Payment Amount |
31819.49 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
138 |
Number Of Male Beneficiaries |
110 |
Number Of Non Hispanic White Beneficiaries |
212 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
219 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1653 |