National Provider Identifier [NPI]: |
1528298031 |
Last Name Of The Provider |
JUN |
First Name Of The Provider |
CHRISTINE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5841 S MARYLAND AVE # MC-5000 |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606371447 |
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 |
14 |
Number Of Services |
760 |
Number Of Medicare Beneficiaries |
309 |
Total Submitted Charge Amount |
264722 |
Total Medicare Allowed Amount |
98380.55 |
Total Medicare Payment Amount |
76468.44 |
Total Medicare Standardized Payment Amount |
71670.88 |
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 |
14 |
Number Of Medical Services |
760 |
Number Of Medicare Beneficiaries With Medical Services |
309 |
Total Medical Submitted Charge Amount |
264722 |
Total Medical Medicare Allowed Amount |
98380.55 |
Total Medical Medicare Payment Amount |
76468.44 |
Total Medical Medicare Standardized Payment Amount |
71670.88 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
176 |
Number Of Male Beneficiaries |
133 |
Number Of Non Hispanic White Beneficiaries |
71 |
Number Of Black or African American Beneficiaries |
206 |
Number Of AsianPacific Islander Beneficiaries |
15 |
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 |
150 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
159 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
72 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
3.2471 |