National Provider Identifier [NPI]: |
1770756215 |
Last Name Of The Provider |
FRISCH |
First Name Of The Provider |
NICHOLAS |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1431 N WESTERN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606221797 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
360 |
Number Of Medicare Beneficiaries |
59 |
Total Submitted Charge Amount |
75226 |
Total Medicare Allowed Amount |
26999.32 |
Total Medicare Payment Amount |
21105.48 |
Total Medicare Standardized Payment Amount |
19049.25 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
224 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
3584 |
Total Drug Medicare AllowedAmount |
395.4 |
Total Drug Medicare PaymentAmount |
310 |
Total Drug Medicare Standardized Payment Amount |
310 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
136 |
Number Of Medicare Beneficiaries With Medical Services |
59 |
Total Medical Submitted Charge Amount |
71642 |
Total Medical Medicare Allowed Amount |
26603.92 |
Total Medical Medicare Payment Amount |
20795.48 |
Total Medical Medicare Standardized Payment Amount |
18739.25 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
20 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
35 |
Number Of Male Beneficiaries |
24 |
Number Of Non Hispanic White Beneficiaries |
14 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
34 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
19 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
25 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
19 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5453 |