National Provider Identifier [NPI]: |
1124051933 |
Last Name Of The Provider |
YEDIDAG |
First Name Of The Provider |
EMRE |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2003 W FULTON ST STE 3 |
Street Address 2 Of The Provider |
C/O MR. SCOTT SCHNEIDER, PRESIDENT |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606122365 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
1103 |
Number Of Medicare Beneficiaries |
430 |
Total Submitted Charge Amount |
151437.9 |
Total Medicare Allowed Amount |
86647.69 |
Total Medicare Payment Amount |
65816.16 |
Total Medicare Standardized Payment Amount |
62436.75 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
75 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
302.25 |
Total Drug Medicare AllowedAmount |
225.11 |
Total Drug Medicare PaymentAmount |
176.53 |
Total Drug Medicare Standardized Payment Amount |
176.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
1028 |
Number Of Medicare Beneficiaries With Medical Services |
430 |
Total Medical Submitted Charge Amount |
151135.65 |
Total Medical Medicare Allowed Amount |
86422.58 |
Total Medical Medicare Payment Amount |
65639.63 |
Total Medical Medicare Standardized Payment Amount |
62260.22 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
83 |
Number Of Beneficiaries Age 75 to 84 |
113 |
Number Of Beneficiaries Age Greater 84 |
169 |
Number Of Female Beneficiaries |
300 |
Number Of Male Beneficiaries |
130 |
Number Of Non Hispanic White Beneficiaries |
181 |
Number Of Black or African American Beneficiaries |
215 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
227 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
203 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
60 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
62 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
3.5397 |