National Provider Identifier [NPI]: |
1093833873 |
Last Name Of The Provider |
FENSKE |
First Name Of The Provider |
GREGG |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1555 BARRINGTON RD |
Street Address 2 Of The Provider |
SUITE 3450 |
City Of The Provider |
HOFFMAN ESTATES |
Zip Code Of The Provider |
601941019 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
1205 |
Number Of Medicare Beneficiaries |
265 |
Total Submitted Charge Amount |
150706 |
Total Medicare Allowed Amount |
101526.35 |
Total Medicare Payment Amount |
72654.2 |
Total Medicare Standardized Payment Amount |
68849.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
72 |
Number Of Medicare Beneficiaries With Drug Services |
62 |
Total Drug Submitted ChargeAmount |
6921 |
Total Drug Medicare AllowedAmount |
4891.33 |
Total Drug Medicare PaymentAmount |
4786.97 |
Total Drug Medicare Standardized Payment Amount |
4786.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
1133 |
Number Of Medicare Beneficiaries With Medical Services |
265 |
Total Medical Submitted Charge Amount |
143785 |
Total Medical Medicare Allowed Amount |
96635.02 |
Total Medical Medicare Payment Amount |
67867.23 |
Total Medical Medicare Standardized Payment Amount |
64062.39 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
141 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
136 |
Number Of Male Beneficiaries |
129 |
Number Of Non Hispanic White Beneficiaries |
243 |
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 |
246 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1017 |