National Provider Identifier [NPI]: |
1336305317 |
Last Name Of The Provider |
KORUTZ |
First Name Of The Provider |
ALEXANDER |
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 |
680 N LAKE SHORE DR |
Street Address 2 Of The Provider |
SUITE 1000 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606114546 |
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 |
27 |
Number Of Services |
435 |
Number Of Medicare Beneficiaries |
325 |
Total Submitted Charge Amount |
149412 |
Total Medicare Allowed Amount |
27386.19 |
Total Medicare Payment Amount |
21260.72 |
Total Medicare Standardized Payment Amount |
20438.64 |
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 |
27 |
Number Of Medical Services |
435 |
Number Of Medicare Beneficiaries With Medical Services |
325 |
Total Medical Submitted Charge Amount |
149412 |
Total Medical Medicare Allowed Amount |
27386.19 |
Total Medical Medicare Payment Amount |
21260.72 |
Total Medical Medicare Standardized Payment Amount |
20438.64 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
142 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
179 |
Number Of Male Beneficiaries |
146 |
Number Of Non Hispanic White Beneficiaries |
205 |
Number Of Black or African American Beneficiaries |
77 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
245 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
27 |
Average HCC Risk Score Of Beneficiaries |
1.6455 |