National Provider Identifier [NPI]: |
1811985443 |
Last Name Of The Provider |
SUKENIK |
First Name Of The Provider |
DMITRY |
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 |
7447 W TALCOTT AVE |
Street Address 2 Of The Provider |
SUITE 304 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606313745 |
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 |
68 |
Number Of Services |
7169 |
Number Of Medicare Beneficiaries |
2854 |
Total Submitted Charge Amount |
2647580 |
Total Medicare Allowed Amount |
477387.19 |
Total Medicare Payment Amount |
368028.8 |
Total Medicare Standardized Payment Amount |
334017.57 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
249 |
Number Of Medicare Beneficiaries With Drug Services |
63 |
Total Drug Submitted ChargeAmount |
39800 |
Total Drug Medicare AllowedAmount |
13139.32 |
Total Drug Medicare PaymentAmount |
10302.91 |
Total Drug Medicare Standardized Payment Amount |
10302.91 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
66 |
Number Of Medical Services |
6920 |
Number Of Medicare Beneficiaries With Medical Services |
2854 |
Total Medical Submitted Charge Amount |
2607780 |
Total Medical Medicare Allowed Amount |
464247.87 |
Total Medical Medicare Payment Amount |
357725.89 |
Total Medical Medicare Standardized Payment Amount |
323714.66 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
282 |
Number Of Beneficiaries Age 65 to 74 |
691 |
Number Of Beneficiaries Age 75 to 84 |
985 |
Number Of Beneficiaries Age Greater 84 |
896 |
Number Of Female Beneficiaries |
1654 |
Number Of Male Beneficiaries |
1200 |
Number Of Non Hispanic White Beneficiaries |
2300 |
Number Of Black or African American Beneficiaries |
218 |
Number Of AsianPacific Islander Beneficiaries |
115 |
Number Of Hispanic Beneficiaries |
175 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1946 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
908 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.0433 |