National Provider Identifier [NPI]: |
1013057488 |
Last Name Of The Provider |
SPARKS |
First Name Of The Provider |
JAY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3231 S NATIONAL AVE |
Street Address 2 Of The Provider |
SUITE 220 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658077304 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
130 |
Number Of Services |
10879 |
Number Of Medicare Beneficiaries |
5950 |
Total Submitted Charge Amount |
1525489.5 |
Total Medicare Allowed Amount |
507475.27 |
Total Medicare Payment Amount |
381423.43 |
Total Medicare Standardized Payment Amount |
434660.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
757 |
Number Of Medicare Beneficiaries With Drug Services |
220 |
Total Drug Submitted ChargeAmount |
47302.5 |
Total Drug Medicare AllowedAmount |
32538.53 |
Total Drug Medicare PaymentAmount |
26609.92 |
Total Drug Medicare Standardized Payment Amount |
26609.92 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
119 |
Number Of Medical Services |
10122 |
Number Of Medicare Beneficiaries With Medical Services |
5950 |
Total Medical Submitted Charge Amount |
1478187 |
Total Medical Medicare Allowed Amount |
474936.74 |
Total Medical Medicare Payment Amount |
354813.51 |
Total Medical Medicare Standardized Payment Amount |
408050.29 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
855 |
Number Of Beneficiaries Age 65 to 74 |
2739 |
Number Of Beneficiaries Age 75 to 84 |
1717 |
Number Of Beneficiaries Age Greater 84 |
639 |
Number Of Female Beneficiaries |
3894 |
Number Of Male Beneficiaries |
2056 |
Number Of Non Hispanic White Beneficiaries |
5753 |
Number Of Black or African American Beneficiaries |
56 |
Number Of AsianPacific Islander Beneficiaries |
25 |
Number Of Hispanic Beneficiaries |
46 |
Number Of American Indian Alaska Native Beneficiaries |
15 |
Number Of Beneficiaries With Race Not Else where Classified |
55 |
Number Of Beneficiaries With Medicare Only Entitlement |
5229 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
721 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0758 |