National Provider Identifier [NPI]: |
1912934456 |
Last Name Of The Provider |
MUNTEANU |
First Name Of The Provider |
ANDRA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
201 E HURON ST |
Street Address 2 Of The Provider |
STE. 11-260 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606113197 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
391 |
Number Of Medicare Beneficiaries |
99 |
Total Submitted Charge Amount |
55955.04 |
Total Medicare Allowed Amount |
35023.16 |
Total Medicare Payment Amount |
26267.36 |
Total Medicare Standardized Payment Amount |
24971.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
41 |
Number Of Medicare Beneficiaries With Drug Services |
27 |
Total Drug Submitted ChargeAmount |
6296 |
Total Drug Medicare AllowedAmount |
2765.81 |
Total Drug Medicare PaymentAmount |
2708.44 |
Total Drug Medicare Standardized Payment Amount |
2708.44 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
350 |
Number Of Medicare Beneficiaries With Medical Services |
99 |
Total Medical Submitted Charge Amount |
49659.04 |
Total Medical Medicare Allowed Amount |
32257.35 |
Total Medical Medicare Payment Amount |
23558.92 |
Total Medical Medicare Standardized Payment Amount |
22263.21 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
25 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
85 |
Number Of Male Beneficiaries |
14 |
Number Of Non Hispanic White Beneficiaries |
53 |
Number Of Black or African American Beneficiaries |
33 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
76 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2024 |