National Provider Identifier [NPI]: |
1396707493 |
Last Name Of The Provider |
SOLARI |
First Name Of The Provider |
MARIANA |
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 |
680 N LAKE SHORE DR |
Street Address 2 Of The Provider |
SUITE 1000 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606114546 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1201 |
Number Of Medicare Beneficiaries |
984 |
Total Submitted Charge Amount |
270555 |
Total Medicare Allowed Amount |
51565.09 |
Total Medicare Payment Amount |
42597.25 |
Total Medicare Standardized Payment Amount |
39549.41 |
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 |
17 |
Number Of Medical Services |
1201 |
Number Of Medicare Beneficiaries With Medical Services |
984 |
Total Medical Submitted Charge Amount |
270555 |
Total Medical Medicare Allowed Amount |
51565.09 |
Total Medical Medicare Payment Amount |
42597.25 |
Total Medical Medicare Standardized Payment Amount |
39549.41 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
622 |
Number Of Beneficiaries Age 75 to 84 |
242 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
667 |
Number Of Black or African American Beneficiaries |
227 |
Number Of AsianPacific Islander Beneficiaries |
23 |
Number Of Hispanic Beneficiaries |
47 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
865 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
119 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
2 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
25 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
14 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
1 |
Average HCC Risk Score Of Beneficiaries |
0.7916 |