National Provider Identifier [NPI]: |
1306929906 |
Last Name Of The Provider |
STEEN |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
619 E MASON ST |
Street Address 2 Of The Provider |
SUITE 4P57 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627011034 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
2165 |
Number Of Medicare Beneficiaries |
1054 |
Total Submitted Charge Amount |
1151051.63 |
Total Medicare Allowed Amount |
241391.53 |
Total Medicare Payment Amount |
182989.8 |
Total Medicare Standardized Payment Amount |
179373.35 |
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 |
48 |
Number Of Medical Services |
2165 |
Number Of Medicare Beneficiaries With Medical Services |
1054 |
Total Medical Submitted Charge Amount |
1151051.63 |
Total Medical Medicare Allowed Amount |
241391.53 |
Total Medical Medicare Payment Amount |
182989.8 |
Total Medical Medicare Standardized Payment Amount |
179373.35 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
115 |
Number Of Beneficiaries Age 65 to 74 |
350 |
Number Of Beneficiaries Age 75 to 84 |
381 |
Number Of Beneficiaries Age Greater 84 |
208 |
Number Of Female Beneficiaries |
472 |
Number Of Male Beneficiaries |
582 |
Number Of Non Hispanic White Beneficiaries |
1012 |
Number Of Black or African American Beneficiaries |
30 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
847 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
207 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.7041 |