National Provider Identifier [NPI]: |
1457359739 |
Last Name Of The Provider |
DEMARCO-PAITL |
First Name Of The Provider |
LAURA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1710 N RANDALL RD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
ELGIN |
Zip Code Of The Provider |
601234717 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
968 |
Number Of Medicare Beneficiaries |
166 |
Total Submitted Charge Amount |
69610 |
Total Medicare Allowed Amount |
47721.69 |
Total Medicare Payment Amount |
36003.61 |
Total Medicare Standardized Payment Amount |
34128.76 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
35 |
Number Of Medicare Beneficiaries With Drug Services |
32 |
Total Drug Submitted ChargeAmount |
1848 |
Total Drug Medicare AllowedAmount |
890.63 |
Total Drug Medicare PaymentAmount |
853.31 |
Total Drug Medicare Standardized Payment Amount |
853.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
933 |
Number Of Medicare Beneficiaries With Medical Services |
166 |
Total Medical Submitted Charge Amount |
67762 |
Total Medical Medicare Allowed Amount |
46831.06 |
Total Medical Medicare Payment Amount |
35150.3 |
Total Medical Medicare Standardized Payment Amount |
33275.45 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
133 |
Number Of Male Beneficiaries |
33 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8519 |