National Provider Identifier [NPI]: |
1033144258 |
Last Name Of The Provider |
RICCIARDI |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
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 |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
894 |
Number Of Medicare Beneficiaries |
468 |
Total Submitted Charge Amount |
1277953.8 |
Total Medicare Allowed Amount |
230874.48 |
Total Medicare Payment Amount |
178492.48 |
Total Medicare Standardized Payment Amount |
156570.49 |
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 |
70 |
Number Of Medical Services |
894 |
Number Of Medicare Beneficiaries With Medical Services |
468 |
Total Medical Submitted Charge Amount |
1277953.8 |
Total Medical Medicare Allowed Amount |
230874.48 |
Total Medical Medicare Payment Amount |
178492.48 |
Total Medical Medicare Standardized Payment Amount |
156570.49 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
94 |
Number Of Beneficiaries Age 65 to 74 |
184 |
Number Of Beneficiaries Age 75 to 84 |
120 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
205 |
Number Of Male Beneficiaries |
263 |
Number Of Non Hispanic White Beneficiaries |
306 |
Number Of Black or African American Beneficiaries |
95 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
37 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
354 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
65 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.6114 |