National Provider Identifier [NPI]: |
1437210267 |
Last Name Of The Provider |
HONG |
First Name Of The Provider |
ANNE |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5841 S MARYLAND AVE |
Street Address 2 Of The Provider |
MC 1099 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606371447 |
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 |
8 |
Number Of Services |
1517 |
Number Of Medicare Beneficiaries |
977 |
Total Submitted Charge Amount |
288018 |
Total Medicare Allowed Amount |
104960.57 |
Total Medicare Payment Amount |
73022.26 |
Total Medicare Standardized Payment Amount |
67640.89 |
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 |
8 |
Number Of Medical Services |
1517 |
Number Of Medicare Beneficiaries With Medical Services |
977 |
Total Medical Submitted Charge Amount |
288018 |
Total Medical Medicare Allowed Amount |
104960.57 |
Total Medical Medicare Payment Amount |
73022.26 |
Total Medical Medicare Standardized Payment Amount |
67640.89 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
209 |
Number Of Beneficiaries Age 65 to 74 |
355 |
Number Of Beneficiaries Age 75 to 84 |
289 |
Number Of Beneficiaries Age Greater 84 |
124 |
Number Of Female Beneficiaries |
713 |
Number Of Male Beneficiaries |
264 |
Number Of Non Hispanic White Beneficiaries |
113 |
Number Of Black or African American Beneficiaries |
802 |
Number Of AsianPacific Islander Beneficiaries |
22 |
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
526 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
451 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.8343 |