National Provider Identifier [NPI]: |
1568412716 |
Last Name Of The Provider |
COOGAN |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1725 W HARRISON ST |
Street Address 2 Of The Provider |
SUITE 758 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606123841 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
68 |
Number Of Services |
5164 |
Number Of Medicare Beneficiaries |
913 |
Total Submitted Charge Amount |
1236512 |
Total Medicare Allowed Amount |
338505.31 |
Total Medicare Payment Amount |
250070.81 |
Total Medicare Standardized Payment Amount |
240416.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
420 |
Number Of Medicare Beneficiaries With Drug Services |
50 |
Total Drug Submitted ChargeAmount |
322112 |
Total Drug Medicare AllowedAmount |
83017.77 |
Total Drug Medicare PaymentAmount |
63075.32 |
Total Drug Medicare Standardized Payment Amount |
63075.32 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
64 |
Number Of Medical Services |
4744 |
Number Of Medicare Beneficiaries With Medical Services |
913 |
Total Medical Submitted Charge Amount |
914400 |
Total Medical Medicare Allowed Amount |
255487.54 |
Total Medical Medicare Payment Amount |
186995.49 |
Total Medical Medicare Standardized Payment Amount |
177341.15 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
417 |
Number Of Beneficiaries Age 75 to 84 |
334 |
Number Of Beneficiaries Age Greater 84 |
82 |
Number Of Female Beneficiaries |
184 |
Number Of Male Beneficiaries |
729 |
Number Of Non Hispanic White Beneficiaries |
589 |
Number Of Black or African American Beneficiaries |
219 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
72 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
19 |
Number Of Beneficiaries With Medicare Only Entitlement |
786 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
127 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
26 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.3348 |