| National Provider Identifier [NPI]: | 1902892607 |
| Last Name Of The Provider | ALLAN |
| First Name Of The Provider | D |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1301 S KOKE MILL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 627119252 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 118 |
| Number Of Services | 7350 |
| Number Of Medicare Beneficiaries | 1083 |
| Total Submitted Charge Amount | 3101959 |
| Total Medicare Allowed Amount | 622004.66 |
| Total Medicare Payment Amount | 462735.84 |
| Total Medicare Standardized Payment Amount | 475731.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2916 |
| Number Of Medicare Beneficiaries With Drug Services | 231 |
| Total Drug Submitted ChargeAmount | 61386 |
| Total Drug Medicare AllowedAmount | 10372.87 |
| Total Drug Medicare PaymentAmount | 7973.5 |
| Total Drug Medicare Standardized Payment Amount | 7973.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 115 |
| Number Of Medical Services | 4434 |
| Number Of Medicare Beneficiaries With Medical Services | 1083 |
| Total Medical Submitted Charge Amount | 3040573 |
| Total Medical Medicare Allowed Amount | 611631.79 |
| Total Medical Medicare Payment Amount | 454762.34 |
| Total Medical Medicare Standardized Payment Amount | 467757.62 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 182 |
| Number Of Beneficiaries Age 65 to 74 | 468 |
| Number Of Beneficiaries Age 75 to 84 | 327 |
| Number Of Beneficiaries Age Greater 84 | 106 |
| Number Of Female Beneficiaries | 667 |
| Number Of Male Beneficiaries | 416 |
| Number Of Non Hispanic White Beneficiaries | 1010 |
| Number Of Black or African American Beneficiaries | 40 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 908 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 175 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2714 |