National Provider Identifier [NPI]: |
1982809356 |
Last Name Of The Provider |
ABRAHAM |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2525 S MICHIGAN AVE |
Street Address 2 Of The Provider |
DEPT OF MEDICINE |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606162333 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1191 |
Number Of Medicare Beneficiaries |
379 |
Total Submitted Charge Amount |
187697 |
Total Medicare Allowed Amount |
106607.26 |
Total Medicare Payment Amount |
74149.84 |
Total Medicare Standardized Payment Amount |
69682.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
47 |
Number Of Medicare Beneficiaries With Drug Services |
46 |
Total Drug Submitted ChargeAmount |
1582 |
Total Drug Medicare AllowedAmount |
690.72 |
Total Drug Medicare PaymentAmount |
676.6 |
Total Drug Medicare Standardized Payment Amount |
676.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
1144 |
Number Of Medicare Beneficiaries With Medical Services |
379 |
Total Medical Submitted Charge Amount |
186115 |
Total Medical Medicare Allowed Amount |
105916.54 |
Total Medical Medicare Payment Amount |
73473.24 |
Total Medical Medicare Standardized Payment Amount |
69005.5 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
138 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
201 |
Number Of Male Beneficiaries |
178 |
Number Of Non Hispanic White Beneficiaries |
37 |
Number Of Black or African American Beneficiaries |
310 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
188 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
191 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.8076 |