National Provider Identifier [NPI]: |
1881781813 |
Last Name Of The Provider |
EXNER |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
101 E MILLER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
STERLING |
Zip Code Of The Provider |
610811252 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
5527 |
Number Of Medicare Beneficiaries |
1194 |
Total Submitted Charge Amount |
408178 |
Total Medicare Allowed Amount |
222818.91 |
Total Medicare Payment Amount |
155089.3 |
Total Medicare Standardized Payment Amount |
155685.39 |
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 |
62 |
Number Of Medical Services |
5527 |
Number Of Medicare Beneficiaries With Medical Services |
1194 |
Total Medical Submitted Charge Amount |
408178 |
Total Medical Medicare Allowed Amount |
222818.91 |
Total Medical Medicare Payment Amount |
155089.3 |
Total Medical Medicare Standardized Payment Amount |
155685.39 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
391 |
Number Of Beneficiaries Age 75 to 84 |
477 |
Number Of Beneficiaries Age Greater 84 |
253 |
Number Of Female Beneficiaries |
636 |
Number Of Male Beneficiaries |
558 |
Number Of Non Hispanic White Beneficiaries |
1156 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1100 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.018 |