National Provider Identifier [NPI]: |
1073537304 |
Last Name Of The Provider |
FELDMAN |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2650 RIDGE AVE |
Street Address 2 Of The Provider |
DEPARTMENT OF PHYS MED SUITE 2204 |
City Of The Provider |
EVANSTON |
Zip Code Of The Provider |
602011718 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
567 |
Number Of Medicare Beneficiaries |
377 |
Total Submitted Charge Amount |
72556 |
Total Medicare Allowed Amount |
44868.16 |
Total Medicare Payment Amount |
32929.04 |
Total Medicare Standardized Payment Amount |
30253.19 |
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 |
19 |
Number Of Medical Services |
567 |
Number Of Medicare Beneficiaries With Medical Services |
377 |
Total Medical Submitted Charge Amount |
72556 |
Total Medical Medicare Allowed Amount |
44868.16 |
Total Medical Medicare Payment Amount |
32929.04 |
Total Medical Medicare Standardized Payment Amount |
30253.19 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
166 |
Number Of Beneficiaries Age 75 to 84 |
136 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
289 |
Number Of Male Beneficiaries |
88 |
Number Of Non Hispanic White Beneficiaries |
336 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
343 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
44 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3935 |