National Provider Identifier [NPI]: |
1962613679 |
Last Name Of The Provider |
CHOI |
First Name Of The Provider |
JENNIFER |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
676 N SAINT CLAIR ST |
Street Address 2 Of The Provider |
SUITE 1600 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606112927 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
3356 |
Number Of Medicare Beneficiaries |
560 |
Total Submitted Charge Amount |
540605 |
Total Medicare Allowed Amount |
199417.89 |
Total Medicare Payment Amount |
147541.74 |
Total Medicare Standardized Payment Amount |
136125.15 |
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 |
53 |
Number Of Medical Services |
3356 |
Number Of Medicare Beneficiaries With Medical Services |
560 |
Total Medical Submitted Charge Amount |
540605 |
Total Medical Medicare Allowed Amount |
199417.89 |
Total Medical Medicare Payment Amount |
147541.74 |
Total Medical Medicare Standardized Payment Amount |
136125.15 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
279 |
Number Of Beneficiaries Age 75 to 84 |
161 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
373 |
Number Of Male Beneficiaries |
187 |
Number Of Non Hispanic White Beneficiaries |
515 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
502 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
1.2027 |