National Provider Identifier [NPI]: |
1700965316 |
Last Name Of The Provider |
CHOJNACKI |
First Name Of The Provider |
ANNA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
836 WELLINGTON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
60657 |
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 |
71 |
Number Of Services |
2916 |
Number Of Medicare Beneficiaries |
1813 |
Total Submitted Charge Amount |
254815 |
Total Medicare Allowed Amount |
82158.37 |
Total Medicare Payment Amount |
66071.56 |
Total Medicare Standardized Payment Amount |
62115.09 |
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 |
71 |
Number Of Medical Services |
2916 |
Number Of Medicare Beneficiaries With Medical Services |
1813 |
Total Medical Submitted Charge Amount |
254815 |
Total Medical Medicare Allowed Amount |
82158.37 |
Total Medical Medicare Payment Amount |
66071.56 |
Total Medical Medicare Standardized Payment Amount |
62115.09 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
265 |
Number Of Beneficiaries Age 65 to 74 |
808 |
Number Of Beneficiaries Age 75 to 84 |
551 |
Number Of Beneficiaries Age Greater 84 |
189 |
Number Of Female Beneficiaries |
1388 |
Number Of Male Beneficiaries |
425 |
Number Of Non Hispanic White Beneficiaries |
1109 |
Number Of Black or African American Beneficiaries |
182 |
Number Of AsianPacific Islander Beneficiaries |
67 |
Number Of Hispanic Beneficiaries |
421 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1255 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
558 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4733 |