National Provider Identifier [NPI]: |
1881692580 |
Last Name Of The Provider |
SPENOS |
First Name Of The Provider |
GUST |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
150 W WASHINGTON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SHELBYVILLE |
Zip Code Of The Provider |
461761236 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
5207 |
Number Of Medicare Beneficiaries |
901 |
Total Submitted Charge Amount |
480250.48 |
Total Medicare Allowed Amount |
320719.66 |
Total Medicare Payment Amount |
239465.94 |
Total Medicare Standardized Payment Amount |
244996.56 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
309 |
Number Of Beneficiaries Age 65 to 74 |
243 |
Number Of Beneficiaries Age 75 to 84 |
227 |
Number Of Beneficiaries Age Greater 84 |
122 |
Number Of Female Beneficiaries |
560 |
Number Of Male Beneficiaries |
341 |
Number Of Non Hispanic White Beneficiaries |
883 |
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 |
521 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
380 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
1.3774 |