| National Provider Identifier [NPI]: | 1790875417 |
| Last Name Of The Provider | KILLOUGH |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1301 DEERPATH ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHARLESTON |
| Zip Code Of The Provider | 619208734 |
| 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 | 47 |
| Number Of Services | 5482 |
| Number Of Medicare Beneficiaries | 1356 |
| Total Submitted Charge Amount | 646432 |
| Total Medicare Allowed Amount | 361341.73 |
| Total Medicare Payment Amount | 253224.6 |
| Total Medicare Standardized Payment Amount | 266485.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 138 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 1842 |
| Total Drug Medicare AllowedAmount | 691.25 |
| Total Drug Medicare PaymentAmount | 540.72 |
| Total Drug Medicare Standardized Payment Amount | 540.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 5344 |
| Number Of Medicare Beneficiaries With Medical Services | 1356 |
| Total Medical Submitted Charge Amount | 644590 |
| Total Medical Medicare Allowed Amount | 360650.48 |
| Total Medical Medicare Payment Amount | 252683.88 |
| Total Medical Medicare Standardized Payment Amount | 265945.13 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 119 |
| Number Of Beneficiaries Age 65 to 74 | 495 |
| Number Of Beneficiaries Age 75 to 84 | 458 |
| Number Of Beneficiaries Age Greater 84 | 284 |
| Number Of Female Beneficiaries | 800 |
| Number Of Male Beneficiaries | 556 |
| Number Of Non Hispanic White Beneficiaries | 1345 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1170 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 186 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.4503 |