National Provider Identifier [NPI]: |
1770570699 |
Last Name Of The Provider |
MIZ |
First Name Of The Provider |
GEORGE |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5540 W 111TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
OAK LAWN |
Zip Code Of The Provider |
604535574 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
1361 |
Number Of Medicare Beneficiaries |
380 |
Total Submitted Charge Amount |
2990649 |
Total Medicare Allowed Amount |
385528.19 |
Total Medicare Payment Amount |
300063.43 |
Total Medicare Standardized Payment Amount |
246528.99 |
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 |
48 |
Number Of Medical Services |
1361 |
Number Of Medicare Beneficiaries With Medical Services |
380 |
Total Medical Submitted Charge Amount |
2990649 |
Total Medical Medicare Allowed Amount |
385528.19 |
Total Medical Medicare Payment Amount |
300063.43 |
Total Medical Medicare Standardized Payment Amount |
246528.99 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
160 |
Number Of Beneficiaries Age 75 to 84 |
124 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
230 |
Number Of Male Beneficiaries |
150 |
Number Of Non Hispanic White Beneficiaries |
275 |
Number Of Black or African American Beneficiaries |
91 |
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 |
315 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1714 |