National Provider Identifier [NPI]: |
1316058043 |
Last Name Of The Provider |
GASKILL |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1515 E LAKE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
HANOVER PARK |
Zip Code Of The Provider |
601334896 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
792 |
Number Of Medicare Beneficiaries |
676 |
Total Submitted Charge Amount |
242208 |
Total Medicare Allowed Amount |
120658.59 |
Total Medicare Payment Amount |
91759.62 |
Total Medicare Standardized Payment Amount |
86001.99 |
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 |
33 |
Number Of Medical Services |
792 |
Number Of Medicare Beneficiaries With Medical Services |
676 |
Total Medical Submitted Charge Amount |
242208 |
Total Medical Medicare Allowed Amount |
120658.59 |
Total Medical Medicare Payment Amount |
91759.62 |
Total Medical Medicare Standardized Payment Amount |
86001.99 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
177 |
Number Of Beneficiaries Age 65 to 74 |
190 |
Number Of Beneficiaries Age 75 to 84 |
173 |
Number Of Beneficiaries Age Greater 84 |
136 |
Number Of Female Beneficiaries |
397 |
Number Of Male Beneficiaries |
279 |
Number Of Non Hispanic White Beneficiaries |
541 |
Number Of Black or African American Beneficiaries |
57 |
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 |
404 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
272 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.8386 |