National Provider Identifier [NPI]: |
1972503886 |
Last Name Of The Provider |
MARKUL |
First Name Of The Provider |
EDDIE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5645 W ADDISON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606344403 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
167 |
Number Of Medicare Beneficiaries |
151 |
Total Submitted Charge Amount |
71738 |
Total Medicare Allowed Amount |
27547.3 |
Total Medicare Payment Amount |
21490.15 |
Total Medicare Standardized Payment Amount |
19811.48 |
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 |
10 |
Number Of Medical Services |
167 |
Number Of Medicare Beneficiaries With Medical Services |
151 |
Total Medical Submitted Charge Amount |
71738 |
Total Medical Medicare Allowed Amount |
27547.3 |
Total Medical Medicare Payment Amount |
21490.15 |
Total Medical Medicare Standardized Payment Amount |
19811.48 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
44 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
83 |
Number Of Male Beneficiaries |
68 |
Number Of Non Hispanic White Beneficiaries |
69 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
44 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
54 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
97 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
21 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.9997 |