National Provider Identifier [NPI]: |
1952394405 |
Last Name Of The Provider |
FEDER |
First Name Of The Provider |
JOEL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
D.P.M. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4211 N CICERO AVE |
Street Address 2 Of The Provider |
SUITE 301 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606411651 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
80 |
Number Of Services |
2125 |
Number Of Medicare Beneficiaries |
374 |
Total Submitted Charge Amount |
347367.91 |
Total Medicare Allowed Amount |
179621.22 |
Total Medicare Payment Amount |
130044.24 |
Total Medicare Standardized Payment Amount |
121599.4 |
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 |
80 |
Number Of Medical Services |
2125 |
Number Of Medicare Beneficiaries With Medical Services |
374 |
Total Medical Submitted Charge Amount |
347367.91 |
Total Medical Medicare Allowed Amount |
179621.22 |
Total Medical Medicare Payment Amount |
130044.24 |
Total Medical Medicare Standardized Payment Amount |
121599.4 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
160 |
Number Of Beneficiaries Age 75 to 84 |
113 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
223 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
295 |
Number Of Black or African American Beneficiaries |
17 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
49 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
318 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.249 |