National Provider Identifier [NPI]: |
1659584530 |
Last Name Of The Provider |
CHUNG |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
675 N SAINT CLAIR ST |
Street Address 2 Of The Provider |
SUITE 20-100 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606115975 |
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 |
66 |
Number Of Services |
1613 |
Number Of Medicare Beneficiaries |
287 |
Total Submitted Charge Amount |
404346 |
Total Medicare Allowed Amount |
73481.84 |
Total Medicare Payment Amount |
55924.74 |
Total Medicare Standardized Payment Amount |
52036.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
984 |
Number Of Medicare Beneficiaries With Drug Services |
104 |
Total Drug Submitted ChargeAmount |
7558 |
Total Drug Medicare AllowedAmount |
1709.39 |
Total Drug Medicare PaymentAmount |
1302.1 |
Total Drug Medicare Standardized Payment Amount |
1302.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
60 |
Number Of Medical Services |
629 |
Number Of Medicare Beneficiaries With Medical Services |
286 |
Total Medical Submitted Charge Amount |
396788 |
Total Medical Medicare Allowed Amount |
71772.45 |
Total Medical Medicare Payment Amount |
54622.64 |
Total Medical Medicare Standardized Payment Amount |
50734.34 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
140 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
173 |
Number Of Male Beneficiaries |
114 |
Number Of Non Hispanic White Beneficiaries |
203 |
Number Of Black or African American Beneficiaries |
53 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
227 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2461 |