National Provider Identifier [NPI]: |
1457379976 |
Last Name Of The Provider |
KONOWITZ |
First Name Of The Provider |
HOWARD |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 WEST NORTH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MELROSE PARK |
Zip Code Of The Provider |
601601612 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
8158 |
Number Of Medicare Beneficiaries |
226 |
Total Submitted Charge Amount |
372163 |
Total Medicare Allowed Amount |
66002.23 |
Total Medicare Payment Amount |
50913.1 |
Total Medicare Standardized Payment Amount |
47377.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
7697 |
Number Of Medicare Beneficiaries With Drug Services |
62 |
Total Drug Submitted ChargeAmount |
34117 |
Total Drug Medicare AllowedAmount |
2105.22 |
Total Drug Medicare PaymentAmount |
1646.38 |
Total Drug Medicare Standardized Payment Amount |
1646.38 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
61 |
Number Of Medical Services |
461 |
Number Of Medicare Beneficiaries With Medical Services |
226 |
Total Medical Submitted Charge Amount |
338046 |
Total Medical Medicare Allowed Amount |
63897.01 |
Total Medical Medicare Payment Amount |
49266.72 |
Total Medical Medicare Standardized Payment Amount |
45731.33 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
89 |
Number Of Beneficiaries Age 75 to 84 |
73 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
138 |
Number Of Male Beneficiaries |
88 |
Number Of Non Hispanic White Beneficiaries |
177 |
Number Of Black or African American Beneficiaries |
|
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 |
181 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
69 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5253 |