National Provider Identifier [NPI]: |
1902835853 |
Last Name Of The Provider |
LURAIN |
First Name Of The Provider |
JOHN |
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 |
680 N LAKE SHORE DR |
Street Address 2 Of The Provider |
SUITE 1000 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606114546 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gynecological/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
134 |
Number Of Services |
58831 |
Number Of Medicare Beneficiaries |
435 |
Total Submitted Charge Amount |
3367823 |
Total Medicare Allowed Amount |
786172.31 |
Total Medicare Payment Amount |
610154.03 |
Total Medicare Standardized Payment Amount |
596458.89 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
55 |
Number Of Drug Services |
56325 |
Number Of Medicare Beneficiaries With Drug Services |
158 |
Total Drug Submitted ChargeAmount |
2394204 |
Total Drug Medicare AllowedAmount |
593284.45 |
Total Drug Medicare PaymentAmount |
462924 |
Total Drug Medicare Standardized Payment Amount |
462924 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
79 |
Number Of Medical Services |
2506 |
Number Of Medicare Beneficiaries With Medical Services |
434 |
Total Medical Submitted Charge Amount |
973619 |
Total Medical Medicare Allowed Amount |
192887.86 |
Total Medical Medicare Payment Amount |
147230.03 |
Total Medical Medicare Standardized Payment Amount |
133534.89 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
214 |
Number Of Beneficiaries Age 75 to 84 |
134 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
424 |
Number Of Male Beneficiaries |
11 |
Number Of Non Hispanic White Beneficiaries |
325 |
Number Of Black or African American Beneficiaries |
65 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
24 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
359 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
76 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
3 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
25 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
15 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.4651 |