National Provider Identifier [NPI]: |
1013015031 |
Last Name Of The Provider |
MCKAY |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2200 WABASH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627045352 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
1925 |
Number Of Medicare Beneficiaries |
307 |
Total Submitted Charge Amount |
78110.46 |
Total Medicare Allowed Amount |
68976.87 |
Total Medicare Payment Amount |
47469.67 |
Total Medicare Standardized Payment Amount |
50079.75 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
119 |
Number Of Medicare Beneficiaries With Drug Services |
78 |
Total Drug Submitted ChargeAmount |
6003.34 |
Total Drug Medicare AllowedAmount |
5451.45 |
Total Drug Medicare PaymentAmount |
5102.3 |
Total Drug Medicare Standardized Payment Amount |
5102.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
1806 |
Number Of Medicare Beneficiaries With Medical Services |
307 |
Total Medical Submitted Charge Amount |
72107.12 |
Total Medical Medicare Allowed Amount |
63525.42 |
Total Medical Medicare Payment Amount |
42367.37 |
Total Medical Medicare Standardized Payment Amount |
44977.45 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
146 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
148 |
Number Of Male Beneficiaries |
159 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
280 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1289 |