National Provider Identifier [NPI]: |
1629057419 |
Last Name Of The Provider |
VANFLEET |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1301 S KOKE MILL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627119252 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
2690 |
Number Of Medicare Beneficiaries |
671 |
Total Submitted Charge Amount |
3594813 |
Total Medicare Allowed Amount |
510425.85 |
Total Medicare Payment Amount |
388851.87 |
Total Medicare Standardized Payment Amount |
359791.35 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
305 |
Number Of Beneficiaries Age 75 to 84 |
206 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
351 |
Number Of Male Beneficiaries |
320 |
Number Of Non Hispanic White Beneficiaries |
643 |
Number Of Black or African American Beneficiaries |
12 |
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 |
561 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
110 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1001 |