National Provider Identifier [NPI]: |
1588618516 |
Last Name Of The Provider |
PHILLIPS |
First Name Of The Provider |
CRAIG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2401 RAVINE WAY |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
GLENVIEW |
Zip Code Of The Provider |
600257645 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hand Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
142 |
Number Of Services |
7782 |
Number Of Medicare Beneficiaries |
913 |
Total Submitted Charge Amount |
1419264 |
Total Medicare Allowed Amount |
457759.59 |
Total Medicare Payment Amount |
345398.22 |
Total Medicare Standardized Payment Amount |
315934.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
3188 |
Number Of Medicare Beneficiaries With Drug Services |
334 |
Total Drug Submitted ChargeAmount |
54252 |
Total Drug Medicare AllowedAmount |
39159.41 |
Total Drug Medicare PaymentAmount |
30641.47 |
Total Drug Medicare Standardized Payment Amount |
30641.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
138 |
Number Of Medical Services |
4594 |
Number Of Medicare Beneficiaries With Medical Services |
913 |
Total Medical Submitted Charge Amount |
1365012 |
Total Medical Medicare Allowed Amount |
418600.18 |
Total Medical Medicare Payment Amount |
314756.75 |
Total Medical Medicare Standardized Payment Amount |
285292.84 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
403 |
Number Of Beneficiaries Age 75 to 84 |
327 |
Number Of Beneficiaries Age Greater 84 |
151 |
Number Of Female Beneficiaries |
599 |
Number Of Male Beneficiaries |
314 |
Number Of Non Hispanic White Beneficiaries |
857 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
21 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
16 |
Number Of Beneficiaries With Medicare Only Entitlement |
875 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.026 |