National Provider Identifier [NPI]: |
1831127430 |
Last Name Of The Provider |
LANDAU |
First Name Of The Provider |
CHAVA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2900 W BIRCHWOOD AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606451220 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
245 |
Number Of Medicare Beneficiaries |
217 |
Total Submitted Charge Amount |
64339 |
Total Medicare Allowed Amount |
41750.57 |
Total Medicare Payment Amount |
32724.22 |
Total Medicare Standardized Payment Amount |
31489.97 |
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 |
20 |
Number Of Medical Services |
245 |
Number Of Medicare Beneficiaries With Medical Services |
217 |
Total Medical Submitted Charge Amount |
64339 |
Total Medical Medicare Allowed Amount |
41750.57 |
Total Medical Medicare Payment Amount |
32724.22 |
Total Medical Medicare Standardized Payment Amount |
31489.97 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
61 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
105 |
Number Of Male Beneficiaries |
112 |
Number Of Non Hispanic White Beneficiaries |
185 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
176 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
10 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2013 |