National Provider Identifier [NPI]: |
1043212780 |
Last Name Of The Provider |
JUN |
First Name Of The Provider |
GREG |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1445 N HUNT CLUB RD |
Street Address 2 Of The Provider |
SUITE 301 |
City Of The Provider |
GURNEE |
Zip Code Of The Provider |
600312603 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
1558 |
Number Of Medicare Beneficiaries |
240 |
Total Submitted Charge Amount |
295584.58 |
Total Medicare Allowed Amount |
98779.81 |
Total Medicare Payment Amount |
73297.45 |
Total Medicare Standardized Payment Amount |
70797.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
60 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
2255.58 |
Total Drug Medicare AllowedAmount |
826.92 |
Total Drug Medicare PaymentAmount |
783.47 |
Total Drug Medicare Standardized Payment Amount |
783.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
52 |
Number Of Medical Services |
1498 |
Number Of Medicare Beneficiaries With Medical Services |
240 |
Total Medical Submitted Charge Amount |
293329 |
Total Medical Medicare Allowed Amount |
97952.89 |
Total Medical Medicare Payment Amount |
72513.98 |
Total Medical Medicare Standardized Payment Amount |
70014.31 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
117 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
193 |
Number Of Black or African American Beneficiaries |
15 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
201 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.303 |