National Provider Identifier [NPI]: |
1326204199 |
Last Name Of The Provider |
JAYCOX |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1653 W CONGRESS PKWY |
Street Address 2 Of The Provider |
DEPT. OF GRADUATE MEDICAL EDUCATION |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606123833 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
121 |
Number Of Services |
2022 |
Number Of Medicare Beneficiaries |
560 |
Total Submitted Charge Amount |
1528618.68 |
Total Medicare Allowed Amount |
182774.53 |
Total Medicare Payment Amount |
138712.33 |
Total Medicare Standardized Payment Amount |
125259.88 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
100 |
Number Of Medicare Beneficiaries With Drug Services |
38 |
Total Drug Submitted ChargeAmount |
2640 |
Total Drug Medicare AllowedAmount |
446.28 |
Total Drug Medicare PaymentAmount |
277.13 |
Total Drug Medicare Standardized Payment Amount |
277.13 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
115 |
Number Of Medical Services |
1922 |
Number Of Medicare Beneficiaries With Medical Services |
560 |
Total Medical Submitted Charge Amount |
1525978.68 |
Total Medical Medicare Allowed Amount |
182328.25 |
Total Medical Medicare Payment Amount |
138435.2 |
Total Medical Medicare Standardized Payment Amount |
124982.75 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
243 |
Number Of Beneficiaries Age 65 to 74 |
195 |
Number Of Beneficiaries Age 75 to 84 |
94 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
363 |
Number Of Male Beneficiaries |
197 |
Number Of Non Hispanic White Beneficiaries |
320 |
Number Of Black or African American Beneficiaries |
168 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
59 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
348 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
212 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
74 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.5989 |