National Provider Identifier [NPI]: |
1245242031 |
Last Name Of The Provider |
KATSNELSON |
First Name Of The Provider |
FLORA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
800 BIESTERFIELD RD |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
ELK GROVE VILLAGE |
Zip Code Of The Provider |
600073311 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
589 |
Number Of Medicare Beneficiaries |
170 |
Total Submitted Charge Amount |
894113 |
Total Medicare Allowed Amount |
285810.98 |
Total Medicare Payment Amount |
222254.84 |
Total Medicare Standardized Payment Amount |
196018.47 |
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 |
28 |
Number Of Medical Services |
589 |
Number Of Medicare Beneficiaries With Medical Services |
170 |
Total Medical Submitted Charge Amount |
894113 |
Total Medical Medicare Allowed Amount |
285810.98 |
Total Medical Medicare Payment Amount |
222254.84 |
Total Medical Medicare Standardized Payment Amount |
196018.47 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
81 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
58 |
Number Of Non Hispanic White Beneficiaries |
147 |
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 |
41 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
129 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2797 |