National Provider Identifier [NPI]: |
1700045184 |
Last Name Of The Provider |
SCHAEFER |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4440 W 95TH ST |
Street Address 2 Of The Provider |
SUITE 407 |
City Of The Provider |
OAK LAWN |
Zip Code Of The Provider |
604532600 |
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 |
100 |
Number Of Services |
634 |
Number Of Medicare Beneficiaries |
310 |
Total Submitted Charge Amount |
551933.1 |
Total Medicare Allowed Amount |
190746.7 |
Total Medicare Payment Amount |
146062.75 |
Total Medicare Standardized Payment Amount |
132410.25 |
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 |
100 |
Number Of Medical Services |
634 |
Number Of Medicare Beneficiaries With Medical Services |
310 |
Total Medical Submitted Charge Amount |
551933.1 |
Total Medical Medicare Allowed Amount |
190746.7 |
Total Medical Medicare Payment Amount |
146062.75 |
Total Medical Medicare Standardized Payment Amount |
132410.25 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
105 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
172 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
193 |
Number Of Black or African American Beneficiaries |
90 |
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 |
225 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
25 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.4728 |