National Provider Identifier [NPI]: |
1861488132 |
Last Name Of The Provider |
WARIKOO |
First Name Of The Provider |
JYOTI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1501 S CALIFORNIA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606081732 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
497 |
Number Of Medicare Beneficiaries |
187 |
Total Submitted Charge Amount |
71590 |
Total Medicare Allowed Amount |
43606.94 |
Total Medicare Payment Amount |
30615.24 |
Total Medicare Standardized Payment Amount |
28769.21 |
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 |
9 |
Number Of Medical Services |
497 |
Number Of Medicare Beneficiaries With Medical Services |
187 |
Total Medical Submitted Charge Amount |
71590 |
Total Medical Medicare Allowed Amount |
43606.94 |
Total Medical Medicare Payment Amount |
30615.24 |
Total Medical Medicare Standardized Payment Amount |
28769.21 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
30 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
124 |
Number Of Male Beneficiaries |
63 |
Number Of Non Hispanic White Beneficiaries |
62 |
Number Of Black or African American Beneficiaries |
99 |
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 |
24 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
163 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
42 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
41 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.8532 |