National Provider Identifier [NPI]: |
1922107838 |
Last Name Of The Provider |
CANEVA |
First Name Of The Provider |
DARYL |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 N HAMMES AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
JOLIET |
Zip Code Of The Provider |
604356677 |
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 |
31 |
Number Of Services |
4424 |
Number Of Medicare Beneficiaries |
1126 |
Total Submitted Charge Amount |
246560.23 |
Total Medicare Allowed Amount |
226024.72 |
Total Medicare Payment Amount |
156465.57 |
Total Medicare Standardized Payment Amount |
148173.25 |
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 |
31 |
Number Of Medical Services |
4424 |
Number Of Medicare Beneficiaries With Medical Services |
1126 |
Total Medical Submitted Charge Amount |
246560.23 |
Total Medical Medicare Allowed Amount |
226024.72 |
Total Medical Medicare Payment Amount |
156465.57 |
Total Medical Medicare Standardized Payment Amount |
148173.25 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
109 |
Number Of Beneficiaries Age 65 to 74 |
390 |
Number Of Beneficiaries Age 75 to 84 |
385 |
Number Of Beneficiaries Age Greater 84 |
242 |
Number Of Female Beneficiaries |
660 |
Number Of Male Beneficiaries |
466 |
Number Of Non Hispanic White Beneficiaries |
895 |
Number Of Black or African American Beneficiaries |
133 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
84 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
938 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
188 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6811 |