National Provider Identifier [NPI]: |
1629059902 |
Last Name Of The Provider |
SZANTO |
First Name Of The Provider |
MARTIN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6374 N LINCOLN AVE |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606591275 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
2434 |
Number Of Medicare Beneficiaries |
340 |
Total Submitted Charge Amount |
239070 |
Total Medicare Allowed Amount |
218942.84 |
Total Medicare Payment Amount |
165975.5 |
Total Medicare Standardized Payment Amount |
149236.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
62 |
Number Of Medicare Beneficiaries With Drug Services |
50 |
Total Drug Submitted ChargeAmount |
1430 |
Total Drug Medicare AllowedAmount |
795.08 |
Total Drug Medicare PaymentAmount |
774.08 |
Total Drug Medicare Standardized Payment Amount |
774.08 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
2372 |
Number Of Medicare Beneficiaries With Medical Services |
340 |
Total Medical Submitted Charge Amount |
237640 |
Total Medical Medicare Allowed Amount |
218147.76 |
Total Medical Medicare Payment Amount |
165201.42 |
Total Medical Medicare Standardized Payment Amount |
148462.9 |
Average Age Of Beneficiaries |
81 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
155 |
Number Of Female Beneficiaries |
212 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
292 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
283 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
57 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
23 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6482 |