National Provider Identifier [NPI]: |
1457666315 |
Last Name Of The Provider |
UGWU |
First Name Of The Provider |
CHUKWUMA |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2900 N LAKE SHORE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606575640 |
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 |
19 |
Number Of Services |
1043 |
Number Of Medicare Beneficiaries |
366 |
Total Submitted Charge Amount |
203338 |
Total Medicare Allowed Amount |
99419.87 |
Total Medicare Payment Amount |
76993.6 |
Total Medicare Standardized Payment Amount |
79267.32 |
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 |
19 |
Number Of Medical Services |
1043 |
Number Of Medicare Beneficiaries With Medical Services |
366 |
Total Medical Submitted Charge Amount |
203338 |
Total Medical Medicare Allowed Amount |
99419.87 |
Total Medical Medicare Payment Amount |
76993.6 |
Total Medical Medicare Standardized Payment Amount |
79267.32 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
111 |
Number Of Female Beneficiaries |
228 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
335 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
251 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
115 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.0139 |