National Provider Identifier [NPI]: |
1972654945 |
Last Name Of The Provider |
LORENZ |
First Name Of The Provider |
JONATHAN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
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 |
91 |
Number Of Services |
1238 |
Number Of Medicare Beneficiaries |
388 |
Total Submitted Charge Amount |
1632691 |
Total Medicare Allowed Amount |
155120.43 |
Total Medicare Payment Amount |
119510.86 |
Total Medicare Standardized Payment Amount |
107667.98 |
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 |
91 |
Number Of Medical Services |
1238 |
Number Of Medicare Beneficiaries With Medical Services |
388 |
Total Medical Submitted Charge Amount |
1632691 |
Total Medical Medicare Allowed Amount |
155120.43 |
Total Medical Medicare Payment Amount |
119510.86 |
Total Medical Medicare Standardized Payment Amount |
107667.98 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
142 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
202 |
Number Of Male Beneficiaries |
186 |
Number Of Non Hispanic White Beneficiaries |
125 |
Number Of Black or African American Beneficiaries |
236 |
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 |
207 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
181 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
71 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
4.5441 |