National Provider Identifier [NPI]: |
1215949789 |
Last Name Of The Provider |
SILAKOWSKI |
First Name Of The Provider |
LINDA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2450 GLENWOOD AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
JOLIET |
Zip Code Of The Provider |
604355463 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
246 |
Number Of Medicare Beneficiaries |
144 |
Total Submitted Charge Amount |
12248.55 |
Total Medicare Allowed Amount |
9897.91 |
Total Medicare Payment Amount |
7078.44 |
Total Medicare Standardized Payment Amount |
8234.52 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
50 |
Number Of Medicare Beneficiaries With Drug Services |
50 |
Total Drug Submitted ChargeAmount |
1690.55 |
Total Drug Medicare AllowedAmount |
1353.97 |
Total Drug Medicare PaymentAmount |
1326.72 |
Total Drug Medicare Standardized Payment Amount |
1326.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
196 |
Number Of Medicare Beneficiaries With Medical Services |
144 |
Total Medical Submitted Charge Amount |
10558 |
Total Medical Medicare Allowed Amount |
8543.94 |
Total Medical Medicare Payment Amount |
5751.72 |
Total Medical Medicare Standardized Payment Amount |
6907.8 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
45 |
Number Of Non Hispanic White Beneficiaries |
114 |
Number Of Black or African American Beneficiaries |
15 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
116 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
|
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9195 |