National Provider Identifier [NPI]: |
1740393594 |
Last Name Of The Provider |
FLESSNER |
First Name Of The Provider |
CYNTHIA |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 N 1ST STREET |
Street Address 2 Of The Provider |
MEMORIAL MEDICAL CENTER DEPT OF PATHOLOGY |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
62781 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
2578 |
Number Of Medicare Beneficiaries |
1083 |
Total Submitted Charge Amount |
640699.2 |
Total Medicare Allowed Amount |
96949.26 |
Total Medicare Payment Amount |
74938.59 |
Total Medicare Standardized Payment Amount |
52846.87 |
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 |
20 |
Number Of Medical Services |
2578 |
Number Of Medicare Beneficiaries With Medical Services |
1083 |
Total Medical Submitted Charge Amount |
640699.2 |
Total Medical Medicare Allowed Amount |
96949.26 |
Total Medical Medicare Payment Amount |
74938.59 |
Total Medical Medicare Standardized Payment Amount |
52846.87 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
184 |
Number Of Beneficiaries Age 65 to 74 |
503 |
Number Of Beneficiaries Age 75 to 84 |
307 |
Number Of Beneficiaries Age Greater 84 |
89 |
Number Of Female Beneficiaries |
580 |
Number Of Male Beneficiaries |
503 |
Number Of Non Hispanic White Beneficiaries |
1029 |
Number Of Black or African American Beneficiaries |
29 |
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 |
884 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
199 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.2188 |