National Provider Identifier [NPI]: |
1629299599 |
Last Name Of The Provider |
HIGH |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
900 N 1ST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627023749 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
87 |
Number Of Services |
660 |
Number Of Medicare Beneficiaries |
267 |
Total Submitted Charge Amount |
219189.95 |
Total Medicare Allowed Amount |
151051.46 |
Total Medicare Payment Amount |
117324.51 |
Total Medicare Standardized Payment Amount |
117402.08 |
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 |
87 |
Number Of Medical Services |
660 |
Number Of Medicare Beneficiaries With Medical Services |
267 |
Total Medical Submitted Charge Amount |
219189.95 |
Total Medical Medicare Allowed Amount |
151051.46 |
Total Medical Medicare Payment Amount |
117324.51 |
Total Medical Medicare Standardized Payment Amount |
117402.08 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
119 |
Number Of Male Beneficiaries |
148 |
Number Of Non Hispanic White Beneficiaries |
254 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
207 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.8585 |