National Provider Identifier [NPI]: |
1982690632 |
Last Name Of The Provider |
ESPINOSA |
First Name Of The Provider |
JOSE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
421 N 9TH ST |
Street Address 2 Of The Provider |
SUITE 240 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627025317 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurosurgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
381 |
Number Of Medicare Beneficiaries |
185 |
Total Submitted Charge Amount |
719684.5 |
Total Medicare Allowed Amount |
102926.42 |
Total Medicare Payment Amount |
79232.66 |
Total Medicare Standardized Payment Amount |
76929.08 |
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 |
64 |
Number Of Medical Services |
381 |
Number Of Medicare Beneficiaries With Medical Services |
185 |
Total Medical Submitted Charge Amount |
719684.5 |
Total Medical Medicare Allowed Amount |
102926.42 |
Total Medical Medicare Payment Amount |
79232.66 |
Total Medical Medicare Standardized Payment Amount |
76929.08 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
42 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
103 |
Number Of Male Beneficiaries |
82 |
Number Of Non Hispanic White Beneficiaries |
171 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
106 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
1.553 |