National Provider Identifier [NPI]: |
1598879223 |
Last Name Of The Provider |
BALDINGER |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1150 W FULLERTON AVE |
Street Address 2 Of The Provider |
2ND FLR |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606148160 |
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 |
475 |
Number Of Medicare Beneficiaries |
84 |
Total Submitted Charge Amount |
69993 |
Total Medicare Allowed Amount |
30399.3 |
Total Medicare Payment Amount |
22088.98 |
Total Medicare Standardized Payment Amount |
21150.81 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
19 |
Number Of Medicare Beneficiaries With Drug Services |
16 |
Total Drug Submitted ChargeAmount |
696 |
Total Drug Medicare AllowedAmount |
461.52 |
Total Drug Medicare PaymentAmount |
452.26 |
Total Drug Medicare Standardized Payment Amount |
452.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
456 |
Number Of Medicare Beneficiaries With Medical Services |
84 |
Total Medical Submitted Charge Amount |
69297 |
Total Medical Medicare Allowed Amount |
29937.78 |
Total Medical Medicare Payment Amount |
21636.72 |
Total Medical Medicare Standardized Payment Amount |
20698.55 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
41 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
34 |
Number Of Male Beneficiaries |
50 |
Number Of Non Hispanic White Beneficiaries |
58 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
67 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
17 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
39 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1329 |