National Provider Identifier [NPI]: |
1710958640 |
Last Name Of The Provider |
SALVACION |
First Name Of The Provider |
FERDINAND |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 N 1ST STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627810001 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
1360 |
Number Of Medicare Beneficiaries |
476 |
Total Submitted Charge Amount |
854402 |
Total Medicare Allowed Amount |
81190.37 |
Total Medicare Payment Amount |
59246.71 |
Total Medicare Standardized Payment Amount |
60584.4 |
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 |
38 |
Number Of Medical Services |
1360 |
Number Of Medicare Beneficiaries With Medical Services |
476 |
Total Medical Submitted Charge Amount |
854402 |
Total Medical Medicare Allowed Amount |
81190.37 |
Total Medical Medicare Payment Amount |
59246.71 |
Total Medical Medicare Standardized Payment Amount |
60584.4 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
193 |
Number Of Beneficiaries Age 65 to 74 |
175 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
289 |
Number Of Male Beneficiaries |
187 |
Number Of Non Hispanic White Beneficiaries |
432 |
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 |
323 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
153 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2692 |