National Provider Identifier [NPI]: |
1740221126 |
Last Name Of The Provider |
HISER |
First Name Of The Provider |
CHRISTY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2100 GLENWOOD AVENUE |
Street Address 2 Of The Provider |
|
City Of The Provider |
JOLIET |
Zip Code Of The Provider |
60435 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
103 |
Number Of Services |
1327 |
Number Of Medicare Beneficiaries |
447 |
Total Submitted Charge Amount |
632198 |
Total Medicare Allowed Amount |
182426.53 |
Total Medicare Payment Amount |
138419.43 |
Total Medicare Standardized Payment Amount |
128500.34 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
218 |
Number Of Beneficiaries Age 75 to 84 |
147 |
Number Of Beneficiaries Age Greater 84 |
56 |
Number Of Female Beneficiaries |
353 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
393 |
Number Of Black or African American Beneficiaries |
32 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
406 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2106 |