National Provider Identifier [NPI]: |
1679675979 |
Last Name Of The Provider |
MISKIEWICZ |
First Name Of The Provider |
CEZARY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
25 N. WINFIELD RD |
Street Address 2 Of The Provider |
CENTRAL DU PAGE HOSPITAL ANESTHESIOLOGY DEPARTMENT |
City Of The Provider |
WINFIELD |
Zip Code Of The Provider |
60190 |
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 |
837 |
Number Of Medicare Beneficiaries |
287 |
Total Submitted Charge Amount |
508194 |
Total Medicare Allowed Amount |
79586.9 |
Total Medicare Payment Amount |
61128.54 |
Total Medicare Standardized Payment Amount |
57075.21 |
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 |
837 |
Number Of Medicare Beneficiaries With Medical Services |
287 |
Total Medical Submitted Charge Amount |
508194 |
Total Medical Medicare Allowed Amount |
79586.9 |
Total Medical Medicare Payment Amount |
61128.54 |
Total Medical Medicare Standardized Payment Amount |
57075.21 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
177 |
Number Of Male Beneficiaries |
110 |
Number Of Non Hispanic White Beneficiaries |
260 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
236 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
51 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
74 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5317 |