National Provider Identifier [NPI]: |
1598942245 |
Last Name Of The Provider |
CHEN |
First Name Of The Provider |
ELAINE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 S PAULINA ST |
Street Address 2 Of The Provider |
SUITE 527 ACADEMIC FACILITY |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606123806 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Critical Care (Intensivists) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
1120 |
Number Of Medicare Beneficiaries |
411 |
Total Submitted Charge Amount |
419145.36 |
Total Medicare Allowed Amount |
153926.32 |
Total Medicare Payment Amount |
118796.75 |
Total Medicare Standardized Payment Amount |
110927.15 |
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 |
36 |
Number Of Medical Services |
1120 |
Number Of Medicare Beneficiaries With Medical Services |
411 |
Total Medical Submitted Charge Amount |
419145.36 |
Total Medical Medicare Allowed Amount |
153926.32 |
Total Medical Medicare Payment Amount |
118796.75 |
Total Medical Medicare Standardized Payment Amount |
110927.15 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
118 |
Number Of Beneficiaries Age 65 to 74 |
146 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
229 |
Number Of Male Beneficiaries |
182 |
Number Of Non Hispanic White Beneficiaries |
156 |
Number Of Black or African American Beneficiaries |
181 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
52 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
214 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
197 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
29 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
57 |
Percent Of With Chronic Kidney Disease |
70 |
Percent Of With Chronic Obstructive Pulmonary Disease |
46 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
3.5858 |