National Provider Identifier [NPI]: |
1104877851 |
Last Name Of The Provider |
LYONS |
First Name Of The Provider |
JACK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2900 N LAKE SHORE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606575640 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
180 |
Number Of Services |
4006 |
Number Of Medicare Beneficiaries |
2282 |
Total Submitted Charge Amount |
500044 |
Total Medicare Allowed Amount |
119096.76 |
Total Medicare Payment Amount |
91259.55 |
Total Medicare Standardized Payment Amount |
86629.2 |
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 |
180 |
Number Of Medical Services |
4006 |
Number Of Medicare Beneficiaries With Medical Services |
2282 |
Total Medical Submitted Charge Amount |
500044 |
Total Medical Medicare Allowed Amount |
119096.76 |
Total Medical Medicare Payment Amount |
91259.55 |
Total Medical Medicare Standardized Payment Amount |
86629.2 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
456 |
Number Of Beneficiaries Age 65 to 74 |
865 |
Number Of Beneficiaries Age 75 to 84 |
596 |
Number Of Beneficiaries Age Greater 84 |
365 |
Number Of Female Beneficiaries |
1438 |
Number Of Male Beneficiaries |
844 |
Number Of Non Hispanic White Beneficiaries |
917 |
Number Of Black or African American Beneficiaries |
619 |
Number Of AsianPacific Islander Beneficiaries |
110 |
Number Of Hispanic Beneficiaries |
595 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1057 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1225 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0536 |