National Provider Identifier [NPI]: |
1376521724 |
Last Name Of The Provider |
STEFOSKI |
First Name Of The Provider |
DUSAN |
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 |
1725 W HARRISON |
Street Address 2 Of The Provider |
#309 UNIVERSITY NEUROLOGISTS MS CENTER |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606123824 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
395 |
Number Of Medicare Beneficiaries |
169 |
Total Submitted Charge Amount |
118929.56 |
Total Medicare Allowed Amount |
49943.8 |
Total Medicare Payment Amount |
34940.58 |
Total Medicare Standardized Payment Amount |
33241.92 |
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 |
18 |
Number Of Medical Services |
395 |
Number Of Medicare Beneficiaries With Medical Services |
169 |
Total Medical Submitted Charge Amount |
118929.56 |
Total Medical Medicare Allowed Amount |
49943.8 |
Total Medical Medicare Payment Amount |
34940.58 |
Total Medical Medicare Standardized Payment Amount |
33241.92 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
104 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
117 |
Number Of Male Beneficiaries |
52 |
Number Of Non Hispanic White Beneficiaries |
146 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
136 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
38 |
Percent Of With Diabetes |
12 |
Percent Of With Hyperlipidemia |
27 |
Percent Of With Hypertension |
30 |
Percent Of With Ischemic Heart Disease |
8 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4222 |