National Provider Identifier [NPI]: |
1396925715 |
Last Name Of The Provider |
BURKE |
First Name Of The Provider |
CAROL |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1700 W VAN BUREN ST |
Street Address 2 Of The Provider |
SUITE 500 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606125500 |
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 |
12 |
Number Of Services |
461 |
Number Of Medicare Beneficiaries |
186 |
Total Submitted Charge Amount |
124503 |
Total Medicare Allowed Amount |
53798.68 |
Total Medicare Payment Amount |
41373.82 |
Total Medicare Standardized Payment Amount |
38699.34 |
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 |
12 |
Number Of Medical Services |
461 |
Number Of Medicare Beneficiaries With Medical Services |
186 |
Total Medical Submitted Charge Amount |
124503 |
Total Medical Medicare Allowed Amount |
53798.68 |
Total Medical Medicare Payment Amount |
41373.82 |
Total Medical Medicare Standardized Payment Amount |
38699.34 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
103 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
39 |
Number Of Black or African American Beneficiaries |
102 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
59 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
127 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
27 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
67 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
3.3365 |