National Provider Identifier [NPI]: |
1588671358 |
Last Name Of The Provider |
NUDELMAN |
First Name Of The Provider |
EARL |
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 |
680 N LAKE SHORE DR |
Street Address 2 Of The Provider |
SUITE 1000 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606114546 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
2489 |
Number Of Medicare Beneficiaries |
1888 |
Total Submitted Charge Amount |
132462 |
Total Medicare Allowed Amount |
28649.43 |
Total Medicare Payment Amount |
20788.14 |
Total Medicare Standardized Payment Amount |
19369.96 |
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 |
66 |
Number Of Medical Services |
2489 |
Number Of Medicare Beneficiaries With Medical Services |
1888 |
Total Medical Submitted Charge Amount |
132462 |
Total Medical Medicare Allowed Amount |
28649.43 |
Total Medical Medicare Payment Amount |
20788.14 |
Total Medical Medicare Standardized Payment Amount |
19369.96 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
325 |
Number Of Beneficiaries Age 65 to 74 |
724 |
Number Of Beneficiaries Age 75 to 84 |
566 |
Number Of Beneficiaries Age Greater 84 |
273 |
Number Of Female Beneficiaries |
1099 |
Number Of Male Beneficiaries |
789 |
Number Of Non Hispanic White Beneficiaries |
1184 |
Number Of Black or African American Beneficiaries |
479 |
Number Of AsianPacific Islander Beneficiaries |
57 |
Number Of Hispanic Beneficiaries |
129 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1396 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
492 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.0516 |