National Provider Identifier [NPI]: |
1588672687 |
Last Name Of The Provider |
MEI |
First Name Of The Provider |
HUBERT |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.C. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
467 W 31ST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606163135 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Chiropractic |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
1 |
Number Of Services |
985 |
Number Of Medicare Beneficiaries |
175 |
Total Submitted Charge Amount |
59100 |
Total Medicare Allowed Amount |
42864.49 |
Total Medicare Payment Amount |
31929.53 |
Total Medicare Standardized Payment Amount |
30480.76 |
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 |
1 |
Number Of Medical Services |
985 |
Number Of Medicare Beneficiaries With Medical Services |
175 |
Total Medical Submitted Charge Amount |
59100 |
Total Medical Medicare Allowed Amount |
42864.49 |
Total Medical Medicare Payment Amount |
31929.53 |
Total Medical Medicare Standardized Payment Amount |
30480.76 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
91 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
108 |
Number Of Male Beneficiaries |
67 |
Number Of Non Hispanic White Beneficiaries |
75 |
Number Of Black or African American Beneficiaries |
51 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
147 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.843 |