National Provider Identifier [NPI]: |
1700081858 |
Last Name Of The Provider |
SIGULINSKY |
First Name Of The Provider |
KARINA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
675 N SAINT CLAIR ST STE 15-150 |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606115976 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
397 |
Number Of Medicare Beneficiaries |
282 |
Total Submitted Charge Amount |
130686 |
Total Medicare Allowed Amount |
44395.95 |
Total Medicare Payment Amount |
31270.12 |
Total Medicare Standardized Payment Amount |
29306.97 |
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 |
12 |
Number Of Medical Services |
397 |
Number Of Medicare Beneficiaries With Medical Services |
282 |
Total Medical Submitted Charge Amount |
130686 |
Total Medical Medicare Allowed Amount |
44395.95 |
Total Medical Medicare Payment Amount |
31270.12 |
Total Medical Medicare Standardized Payment Amount |
29306.97 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
129 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
183 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
141 |
Number Of Black or African American Beneficiaries |
89 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
33 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
200 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
82 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.1615 |