National Provider Identifier [NPI]: |
1457327173 |
Last Name Of The Provider |
OBARSKI |
First Name Of The Provider |
KENNETH |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
425 HUEHL RD |
Street Address 2 Of The Provider |
UNIT 13 |
City Of The Provider |
NORTHBROOK |
Zip Code Of The Provider |
600622322 |
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 |
20 |
Number Of Services |
4723 |
Number Of Medicare Beneficiaries |
1120 |
Total Submitted Charge Amount |
195927 |
Total Medicare Allowed Amount |
165334.03 |
Total Medicare Payment Amount |
122510.73 |
Total Medicare Standardized Payment Amount |
130138.83 |
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 |
20 |
Number Of Medical Services |
4723 |
Number Of Medicare Beneficiaries With Medical Services |
1120 |
Total Medical Submitted Charge Amount |
195927 |
Total Medical Medicare Allowed Amount |
165334.03 |
Total Medical Medicare Payment Amount |
122510.73 |
Total Medical Medicare Standardized Payment Amount |
130138.83 |
Average Age Of Beneficiaries |
83 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
318 |
Number Of Beneficiaries Age Greater 84 |
576 |
Number Of Female Beneficiaries |
736 |
Number Of Male Beneficiaries |
384 |
Number Of Non Hispanic White Beneficiaries |
943 |
Number Of Black or African American Beneficiaries |
143 |
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 |
339 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
781 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
30 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.2926 |