National Provider Identifier [NPI]: |
1245423284 |
Last Name Of The Provider |
LIU |
First Name Of The Provider |
LIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2650 RIDGE AVE |
Street Address 2 Of The Provider |
EVANSTON HOSPITAL |
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 |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
3563 |
Number Of Medicare Beneficiaries |
1398 |
Total Submitted Charge Amount |
564707 |
Total Medicare Allowed Amount |
143535.14 |
Total Medicare Payment Amount |
110387.34 |
Total Medicare Standardized Payment Amount |
101368.08 |
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 |
31 |
Number Of Medical Services |
3563 |
Number Of Medicare Beneficiaries With Medical Services |
1398 |
Total Medical Submitted Charge Amount |
564707 |
Total Medical Medicare Allowed Amount |
143535.14 |
Total Medical Medicare Payment Amount |
110387.34 |
Total Medical Medicare Standardized Payment Amount |
101368.08 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
585 |
Number Of Beneficiaries Age 75 to 84 |
534 |
Number Of Beneficiaries Age Greater 84 |
210 |
Number Of Female Beneficiaries |
779 |
Number Of Male Beneficiaries |
619 |
Number Of Non Hispanic White Beneficiaries |
1210 |
Number Of Black or African American Beneficiaries |
58 |
Number Of AsianPacific Islander Beneficiaries |
59 |
Number Of Hispanic Beneficiaries |
40 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
31 |
Number Of Beneficiaries With Medicare Only Entitlement |
1241 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
157 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
27 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.304 |