National Provider Identifier [NPI]: |
1881851152 |
Last Name Of The Provider |
BRUGGER |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1700 W VAN BUREN ST |
Street Address 2 Of The Provider |
SUITE 500 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606125500 |
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 |
20 |
Number Of Services |
1769 |
Number Of Medicare Beneficiaries |
611 |
Total Submitted Charge Amount |
409949 |
Total Medicare Allowed Amount |
169884.85 |
Total Medicare Payment Amount |
129108.3 |
Total Medicare Standardized Payment Amount |
121804.13 |
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 |
20 |
Number Of Medical Services |
1769 |
Number Of Medicare Beneficiaries With Medical Services |
611 |
Total Medical Submitted Charge Amount |
409949 |
Total Medical Medicare Allowed Amount |
169884.85 |
Total Medical Medicare Payment Amount |
129108.3 |
Total Medical Medicare Standardized Payment Amount |
121804.13 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
144 |
Number Of Beneficiaries Age 65 to 74 |
247 |
Number Of Beneficiaries Age 75 to 84 |
160 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
377 |
Number Of Male Beneficiaries |
234 |
Number Of Non Hispanic White Beneficiaries |
323 |
Number Of Black or African American Beneficiaries |
204 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
62 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
387 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
224 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.333 |