National Provider Identifier [NPI]: |
1568494987 |
Last Name Of The Provider |
D'AGOSTINO |
First Name Of The Provider |
CHRIS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1786 MOON LAKE BLVD |
Street Address 2 Of The Provider |
SUITE 104 |
City Of The Provider |
HOFFMAN ESTATES |
Zip Code Of The Provider |
601945029 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
3244 |
Number Of Medicare Beneficiaries |
873 |
Total Submitted Charge Amount |
567085 |
Total Medicare Allowed Amount |
304580.27 |
Total Medicare Payment Amount |
231050.67 |
Total Medicare Standardized Payment Amount |
220446.78 |
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 |
24 |
Number Of Medical Services |
3244 |
Number Of Medicare Beneficiaries With Medical Services |
873 |
Total Medical Submitted Charge Amount |
567085 |
Total Medical Medicare Allowed Amount |
304580.27 |
Total Medical Medicare Payment Amount |
231050.67 |
Total Medical Medicare Standardized Payment Amount |
220446.78 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
78 |
Number Of Beneficiaries Age 65 to 74 |
178 |
Number Of Beneficiaries Age 75 to 84 |
303 |
Number Of Beneficiaries Age Greater 84 |
314 |
Number Of Female Beneficiaries |
594 |
Number Of Male Beneficiaries |
279 |
Number Of Non Hispanic White Beneficiaries |
823 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
706 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
167 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
65 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
40 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.6215 |