National Provider Identifier [NPI]: |
1043361017 |
Last Name Of The Provider |
SENNETT |
First Name Of The Provider |
CHARLENE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
180 HARVESTER DR STE 110 |
Street Address 2 Of The Provider |
|
City Of The Provider |
BURR RIDGE |
Zip Code Of The Provider |
605276686 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
2552 |
Number Of Medicare Beneficiaries |
1140 |
Total Submitted Charge Amount |
392690 |
Total Medicare Allowed Amount |
65186.32 |
Total Medicare Payment Amount |
51094.1 |
Total Medicare Standardized Payment Amount |
47461.96 |
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 |
20 |
Number Of Medical Services |
2552 |
Number Of Medicare Beneficiaries With Medical Services |
1140 |
Total Medical Submitted Charge Amount |
392690 |
Total Medical Medicare Allowed Amount |
65186.32 |
Total Medical Medicare Payment Amount |
51094.1 |
Total Medical Medicare Standardized Payment Amount |
47461.96 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
196 |
Number Of Beneficiaries Age 65 to 74 |
563 |
Number Of Beneficiaries Age 75 to 84 |
303 |
Number Of Beneficiaries Age Greater 84 |
78 |
Number Of Female Beneficiaries |
1127 |
Number Of Male Beneficiaries |
13 |
Number Of Non Hispanic White Beneficiaries |
331 |
Number Of Black or African American Beneficiaries |
764 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
803 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
337 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
34 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2104 |