National Provider Identifier [NPI]: |
1285890863 |
Last Name Of The Provider |
O'LEARY |
First Name Of The Provider |
MICHELLE |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
333 MADISON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
JOLIET |
Zip Code Of The Provider |
604358200 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
5688 |
Number Of Medicare Beneficiaries |
1547 |
Total Submitted Charge Amount |
669023 |
Total Medicare Allowed Amount |
179028.3 |
Total Medicare Payment Amount |
140149.66 |
Total Medicare Standardized Payment Amount |
128166.29 |
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 |
32 |
Number Of Medical Services |
5688 |
Number Of Medicare Beneficiaries With Medical Services |
1547 |
Total Medical Submitted Charge Amount |
669023 |
Total Medical Medicare Allowed Amount |
179028.3 |
Total Medical Medicare Payment Amount |
140149.66 |
Total Medical Medicare Standardized Payment Amount |
128166.29 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
191 |
Number Of Beneficiaries Age 65 to 74 |
611 |
Number Of Beneficiaries Age 75 to 84 |
480 |
Number Of Beneficiaries Age Greater 84 |
265 |
Number Of Female Beneficiaries |
897 |
Number Of Male Beneficiaries |
650 |
Number Of Non Hispanic White Beneficiaries |
1303 |
Number Of Black or African American Beneficiaries |
145 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
77 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1236 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
311 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.9149 |