National Provider Identifier [NPI]: |
1629188958 |
Last Name Of The Provider |
BLAND |
First Name Of The Provider |
GEOFFREY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2200 WABASH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627045352 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
2748 |
Number Of Medicare Beneficiaries |
618 |
Total Submitted Charge Amount |
91557.98 |
Total Medicare Allowed Amount |
82665.91 |
Total Medicare Payment Amount |
54941.45 |
Total Medicare Standardized Payment Amount |
57640.4 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
185 |
Number Of Medicare Beneficiaries With Drug Services |
115 |
Total Drug Submitted ChargeAmount |
5269.64 |
Total Drug Medicare AllowedAmount |
4854.23 |
Total Drug Medicare PaymentAmount |
4716.6 |
Total Drug Medicare Standardized Payment Amount |
4716.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
2563 |
Number Of Medicare Beneficiaries With Medical Services |
618 |
Total Medical Submitted Charge Amount |
86288.34 |
Total Medical Medicare Allowed Amount |
77811.68 |
Total Medical Medicare Payment Amount |
50224.85 |
Total Medical Medicare Standardized Payment Amount |
52923.8 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
301 |
Number Of Beneficiaries Age 75 to 84 |
178 |
Number Of Beneficiaries Age Greater 84 |
74 |
Number Of Female Beneficiaries |
321 |
Number Of Male Beneficiaries |
297 |
Number Of Non Hispanic White Beneficiaries |
584 |
Number Of Black or African American Beneficiaries |
16 |
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 |
579 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
1.0392 |