National Provider Identifier [NPI]: |
1841286770 |
Last Name Of The Provider |
KOENIGSBERG |
First Name Of The Provider |
DAVID |
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 |
233 E ERIE ST |
Street Address 2 Of The Provider |
SUITE 500 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606112926 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
857 |
Number Of Medicare Beneficiaries |
281 |
Total Submitted Charge Amount |
424857 |
Total Medicare Allowed Amount |
140574.39 |
Total Medicare Payment Amount |
105519.52 |
Total Medicare Standardized Payment Amount |
98169.01 |
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 |
41 |
Number Of Medical Services |
857 |
Number Of Medicare Beneficiaries With Medical Services |
281 |
Total Medical Submitted Charge Amount |
424857 |
Total Medical Medicare Allowed Amount |
140574.39 |
Total Medical Medicare Payment Amount |
105519.52 |
Total Medical Medicare Standardized Payment Amount |
98169.01 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
108 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
121 |
Number Of Male Beneficiaries |
160 |
Number Of Non Hispanic White Beneficiaries |
230 |
Number Of Black or African American Beneficiaries |
17 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
250 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.4244 |