National Provider Identifier [NPI]: |
1356367338 |
Last Name Of The Provider |
TA |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
181 S. LINCOLNWAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORTH AURORA |
Zip Code Of The Provider |
60542 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
8016 |
Number Of Medicare Beneficiaries |
735 |
Total Submitted Charge Amount |
348525.82 |
Total Medicare Allowed Amount |
335122.43 |
Total Medicare Payment Amount |
248026.93 |
Total Medicare Standardized Payment Amount |
231643.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
5309 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
69123.18 |
Total Drug Medicare AllowedAmount |
68350.8 |
Total Drug Medicare PaymentAmount |
53568.32 |
Total Drug Medicare Standardized Payment Amount |
53568.32 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
2707 |
Number Of Medicare Beneficiaries With Medical Services |
735 |
Total Medical Submitted Charge Amount |
279402.64 |
Total Medical Medicare Allowed Amount |
266771.63 |
Total Medical Medicare Payment Amount |
194458.61 |
Total Medical Medicare Standardized Payment Amount |
178075.04 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
258 |
Number Of Beneficiaries Age 75 to 84 |
234 |
Number Of Beneficiaries Age Greater 84 |
140 |
Number Of Female Beneficiaries |
431 |
Number Of Male Beneficiaries |
304 |
Number Of Non Hispanic White Beneficiaries |
687 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
567 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
168 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.4941 |