| National Provider Identifier [NPI]: | 1437195567 |
| Last Name Of The Provider | JORGENSON |
| First Name Of The Provider | RYAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | PREFERRED PODIATRY GROUP |
| Street Address 2 Of The Provider | 425 HUEHL ROAD #13 |
| City Of The Provider | NORTHBROOK |
| Zip Code Of The Provider | 60062 |
| 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 | 21 |
| Number Of Services | 11667 |
| Number Of Medicare Beneficiaries | 2077 |
| Total Submitted Charge Amount | 480625.1 |
| Total Medicare Allowed Amount | 403290.32 |
| Total Medicare Payment Amount | 305809.34 |
| Total Medicare Standardized Payment Amount | 324912.44 |
| 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 | 21 |
| Number Of Medical Services | 11667 |
| Number Of Medicare Beneficiaries With Medical Services | 2077 |
| Total Medical Submitted Charge Amount | 480625.1 |
| Total Medical Medicare Allowed Amount | 403290.32 |
| Total Medical Medicare Payment Amount | 305809.34 |
| Total Medical Medicare Standardized Payment Amount | 324912.44 |
| Average Age Of Beneficiaries | 85 |
| Number Of Beneficiaries Age Less65 | 90 |
| Number Of Beneficiaries Age 65 to 74 | 217 |
| Number Of Beneficiaries Age 75 to 84 | 533 |
| Number Of Beneficiaries Age Greater 84 | 1237 |
| Number Of Female Beneficiaries | 1474 |
| Number Of Male Beneficiaries | 603 |
| Number Of Non Hispanic White Beneficiaries | 1978 |
| Number Of Black or African American Beneficiaries | 71 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| 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 | 1121 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 956 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 68 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 22 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9353 |