| National Provider Identifier [NPI]: | 1710952999 |
| Last Name Of The Provider | POOLE |
| First Name Of The Provider | JERRY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4346 N BROADWAY ST |
| Street Address 2 Of The Provider | AGGEUS HEALTHCARE PC |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606131403 |
| 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 | 13328 |
| Number Of Medicare Beneficiaries | 2631 |
| Total Submitted Charge Amount | 567657.3 |
| Total Medicare Allowed Amount | 557222.5 |
| Total Medicare Payment Amount | 401528.4 |
| Total Medicare Standardized Payment Amount | 419840.6 |
| 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 | 13328 |
| Number Of Medicare Beneficiaries With Medical Services | 2631 |
| Total Medical Submitted Charge Amount | 567657.3 |
| Total Medical Medicare Allowed Amount | 557222.5 |
| Total Medical Medicare Payment Amount | 401528.4 |
| Total Medical Medicare Standardized Payment Amount | 419840.6 |
| Average Age Of Beneficiaries | 85 |
| Number Of Beneficiaries Age Less65 | 95 |
| Number Of Beneficiaries Age 65 to 74 | 220 |
| Number Of Beneficiaries Age 75 to 84 | 651 |
| Number Of Beneficiaries Age Greater 84 | 1665 |
| Number Of Female Beneficiaries | 1793 |
| Number Of Male Beneficiaries | 838 |
| Number Of Non Hispanic White Beneficiaries | 2458 |
| Number Of Black or African American Beneficiaries | 123 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1229 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1402 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 73 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 18 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8562 |