National Provider Identifier [NPI]: |
1093972150 |
Last Name Of The Provider |
KINONEN |
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 |
5841 S MARYLAND AVE # MC5067 |
Street Address 2 Of The Provider |
DERMATOLOGY |
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 |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
3255 |
Number Of Medicare Beneficiaries |
1255 |
Total Submitted Charge Amount |
803975 |
Total Medicare Allowed Amount |
106903.66 |
Total Medicare Payment Amount |
82828.01 |
Total Medicare Standardized Payment Amount |
66403.48 |
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 |
26 |
Number Of Medical Services |
3255 |
Number Of Medicare Beneficiaries With Medical Services |
1255 |
Total Medical Submitted Charge Amount |
803975 |
Total Medical Medicare Allowed Amount |
106903.66 |
Total Medical Medicare Payment Amount |
82828.01 |
Total Medical Medicare Standardized Payment Amount |
66403.48 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
128 |
Number Of Beneficiaries Age 65 to 74 |
555 |
Number Of Beneficiaries Age 75 to 84 |
406 |
Number Of Beneficiaries Age Greater 84 |
166 |
Number Of Female Beneficiaries |
685 |
Number Of Male Beneficiaries |
570 |
Number Of Non Hispanic White Beneficiaries |
1203 |
Number Of Black or African American Beneficiaries |
13 |
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 |
19 |
Number Of Beneficiaries With Medicare Only Entitlement |
1098 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
157 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0281 |