National Provider Identifier [NPI]: |
1619997293 |
Last Name Of The Provider |
MYERS |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1653 W CONGRESS PKWY |
Street Address 2 Of The Provider |
735 JELKE ANESTHESIA DEPARTMENT |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606123833 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
76 |
Number Of Services |
414 |
Number Of Medicare Beneficiaries |
353 |
Total Submitted Charge Amount |
645370.25 |
Total Medicare Allowed Amount |
70010.01 |
Total Medicare Payment Amount |
54741.55 |
Total Medicare Standardized Payment Amount |
49371.92 |
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 |
76 |
Number Of Medical Services |
414 |
Number Of Medicare Beneficiaries With Medical Services |
353 |
Total Medical Submitted Charge Amount |
645370.25 |
Total Medical Medicare Allowed Amount |
70010.01 |
Total Medical Medicare Payment Amount |
54741.55 |
Total Medical Medicare Standardized Payment Amount |
49371.92 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
97 |
Number Of Beneficiaries Age 65 to 74 |
147 |
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
210 |
Number Of Male Beneficiaries |
143 |
Number Of Non Hispanic White Beneficiaries |
188 |
Number Of Black or African American Beneficiaries |
124 |
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 |
239 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.9312 |