National Provider Identifier [NPI]: |
1023127230 |
Last Name Of The Provider |
HALEK |
First Name Of The Provider |
WALTER |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5618 S PULASKI RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
60629 |
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 |
19 |
Number Of Services |
6628 |
Number Of Medicare Beneficiaries |
953 |
Total Submitted Charge Amount |
404385 |
Total Medicare Allowed Amount |
277474.27 |
Total Medicare Payment Amount |
214663.71 |
Total Medicare Standardized Payment Amount |
202689.6 |
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 |
19 |
Number Of Medical Services |
6628 |
Number Of Medicare Beneficiaries With Medical Services |
953 |
Total Medical Submitted Charge Amount |
404385 |
Total Medical Medicare Allowed Amount |
277474.27 |
Total Medical Medicare Payment Amount |
214663.71 |
Total Medical Medicare Standardized Payment Amount |
202689.6 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
117 |
Number Of Beneficiaries Age 65 to 74 |
212 |
Number Of Beneficiaries Age 75 to 84 |
266 |
Number Of Beneficiaries Age Greater 84 |
358 |
Number Of Female Beneficiaries |
598 |
Number Of Male Beneficiaries |
355 |
Number Of Non Hispanic White Beneficiaries |
491 |
Number Of Black or African American Beneficiaries |
393 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
42 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
319 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
634 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
62 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
24 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.4845 |