National Provider Identifier [NPI]: |
1952491243 |
Last Name Of The Provider |
SFEIR |
First Name Of The Provider |
HADY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5105 GLEN PARK PL |
Street Address 2 Of The Provider |
|
City Of The Provider |
PEORIA |
Zip Code Of The Provider |
616144688 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
3602 |
Number Of Medicare Beneficiaries |
588 |
Total Submitted Charge Amount |
298215 |
Total Medicare Allowed Amount |
139269.52 |
Total Medicare Payment Amount |
101840.92 |
Total Medicare Standardized Payment Amount |
103843.87 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
2172 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
65174 |
Total Drug Medicare AllowedAmount |
31409.89 |
Total Drug Medicare PaymentAmount |
24446.88 |
Total Drug Medicare Standardized Payment Amount |
24446.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
1430 |
Number Of Medicare Beneficiaries With Medical Services |
587 |
Total Medical Submitted Charge Amount |
233041 |
Total Medical Medicare Allowed Amount |
107859.63 |
Total Medical Medicare Payment Amount |
77394.04 |
Total Medical Medicare Standardized Payment Amount |
79396.99 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
119 |
Number Of Beneficiaries Age 65 to 74 |
304 |
Number Of Beneficiaries Age 75 to 84 |
141 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
347 |
Number Of Male Beneficiaries |
241 |
Number Of Non Hispanic White Beneficiaries |
509 |
Number Of Black or African American Beneficiaries |
55 |
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 |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
480 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
108 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
69 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.2283 |