National Provider Identifier [NPI]: |
1558438861 |
Last Name Of The Provider |
MENDELSON |
First Name Of The Provider |
ALBERT |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1800 HOLLISTER DR |
Street Address 2 Of The Provider |
SUITE G-18 |
City Of The Provider |
LIBERTYVILLE |
Zip Code Of The Provider |
600485263 |
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 |
111 |
Number Of Services |
1994 |
Number Of Medicare Beneficiaries |
1294 |
Total Submitted Charge Amount |
497877 |
Total Medicare Allowed Amount |
91413.9 |
Total Medicare Payment Amount |
69109.86 |
Total Medicare Standardized Payment Amount |
65856.29 |
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 |
111 |
Number Of Medical Services |
1994 |
Number Of Medicare Beneficiaries With Medical Services |
1294 |
Total Medical Submitted Charge Amount |
497877 |
Total Medical Medicare Allowed Amount |
91413.9 |
Total Medical Medicare Payment Amount |
69109.86 |
Total Medical Medicare Standardized Payment Amount |
65856.29 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
126 |
Number Of Beneficiaries Age 65 to 74 |
524 |
Number Of Beneficiaries Age 75 to 84 |
412 |
Number Of Beneficiaries Age Greater 84 |
232 |
Number Of Female Beneficiaries |
747 |
Number Of Male Beneficiaries |
547 |
Number Of Non Hispanic White Beneficiaries |
1113 |
Number Of Black or African American Beneficiaries |
87 |
Number Of AsianPacific Islander Beneficiaries |
28 |
Number Of Hispanic Beneficiaries |
51 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1143 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
151 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4494 |