National Provider Identifier [NPI]: |
1700963600 |
Last Name Of The Provider |
KONDOS |
First Name Of The Provider |
GEORGE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
820 S DAMEN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606123728 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
409 |
Number Of Medicare Beneficiaries |
308 |
Total Submitted Charge Amount |
99398 |
Total Medicare Allowed Amount |
34828.52 |
Total Medicare Payment Amount |
25286.45 |
Total Medicare Standardized Payment Amount |
23383.45 |
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 |
13 |
Number Of Medical Services |
409 |
Number Of Medicare Beneficiaries With Medical Services |
308 |
Total Medical Submitted Charge Amount |
99398 |
Total Medical Medicare Allowed Amount |
34828.52 |
Total Medical Medicare Payment Amount |
25286.45 |
Total Medical Medicare Standardized Payment Amount |
23383.45 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
136 |
Number Of Beneficiaries Age 75 to 84 |
83 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
134 |
Number Of Male Beneficiaries |
174 |
Number Of Non Hispanic White Beneficiaries |
127 |
Number Of Black or African American Beneficiaries |
105 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
58 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
183 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.0193 |