| National Provider Identifier [NPI]: | 1043405608 |
| Last Name Of The Provider | PURVES |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 N 1ST ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 627023719 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 1694 |
| Number Of Medicare Beneficiaries | 454 |
| Total Submitted Charge Amount | 97905.42 |
| Total Medicare Allowed Amount | 69575.02 |
| Total Medicare Payment Amount | 50158.3 |
| Total Medicare Standardized Payment Amount | 58175.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 687 |
| Number Of Medicare Beneficiaries With Drug Services | 224 |
| Total Drug Submitted ChargeAmount | 16835.26 |
| Total Drug Medicare AllowedAmount | 15417.91 |
| Total Drug Medicare PaymentAmount | 11546.44 |
| Total Drug Medicare Standardized Payment Amount | 11546.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 1007 |
| Number Of Medicare Beneficiaries With Medical Services | 454 |
| Total Medical Submitted Charge Amount | 81070.16 |
| Total Medical Medicare Allowed Amount | 54157.11 |
| Total Medical Medicare Payment Amount | 38611.86 |
| Total Medical Medicare Standardized Payment Amount | 46629.51 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 228 |
| Number Of Beneficiaries Age 75 to 84 | 114 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 272 |
| Number Of Male Beneficiaries | 182 |
| Number Of Non Hispanic White Beneficiaries | 423 |
| 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 | 390 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0431 |