National Provider Identifier [NPI]: |
1669614392 |
Last Name Of The Provider |
GLASSMAN |
First Name Of The Provider |
ADAM |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7435 W TALCOTT AVE |
Street Address 2 Of The Provider |
RESURRECTION EMERGENCY MEDICINE RESIDENCY |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606313707 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1079 |
Number Of Medicare Beneficiaries |
919 |
Total Submitted Charge Amount |
601660 |
Total Medicare Allowed Amount |
174751.86 |
Total Medicare Payment Amount |
133764.11 |
Total Medicare Standardized Payment Amount |
125901.92 |
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 |
29 |
Number Of Medical Services |
1079 |
Number Of Medicare Beneficiaries With Medical Services |
919 |
Total Medical Submitted Charge Amount |
601660 |
Total Medical Medicare Allowed Amount |
174751.86 |
Total Medical Medicare Payment Amount |
133764.11 |
Total Medical Medicare Standardized Payment Amount |
125901.92 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
184 |
Number Of Beneficiaries Age 65 to 74 |
265 |
Number Of Beneficiaries Age 75 to 84 |
288 |
Number Of Beneficiaries Age Greater 84 |
182 |
Number Of Female Beneficiaries |
537 |
Number Of Male Beneficiaries |
382 |
Number Of Non Hispanic White Beneficiaries |
743 |
Number Of Black or African American Beneficiaries |
46 |
Number Of AsianPacific Islander Beneficiaries |
22 |
Number Of Hispanic Beneficiaries |
92 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
661 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
258 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.0667 |