National Provider Identifier [NPI]: |
1740212646 |
Last Name Of The Provider |
BAREIS |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3231 EUCLID AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BERWYN |
Zip Code Of The Provider |
604023471 |
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 |
34 |
Number Of Services |
453 |
Number Of Medicare Beneficiaries |
84 |
Total Submitted Charge Amount |
71210 |
Total Medicare Allowed Amount |
30779.51 |
Total Medicare Payment Amount |
22385.23 |
Total Medicare Standardized Payment Amount |
21187.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
45 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
2384 |
Total Drug Medicare AllowedAmount |
1789.83 |
Total Drug Medicare PaymentAmount |
1751.37 |
Total Drug Medicare Standardized Payment Amount |
1751.37 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
408 |
Number Of Medicare Beneficiaries With Medical Services |
84 |
Total Medical Submitted Charge Amount |
68826 |
Total Medical Medicare Allowed Amount |
28989.68 |
Total Medical Medicare Payment Amount |
20633.86 |
Total Medical Medicare Standardized Payment Amount |
19435.66 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
38 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
46 |
Number Of Male Beneficiaries |
38 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0837 |