National Provider Identifier [NPI]: |
1245256965 |
Last Name Of The Provider |
THAKKAR |
First Name Of The Provider |
PARAG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1170 E BELVIDERE RD |
Street Address 2 Of The Provider |
SUITE 210 |
City Of The Provider |
GRAYSLAKE |
Zip Code Of The Provider |
600302061 |
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 |
51 |
Number Of Services |
1662 |
Number Of Medicare Beneficiaries |
263 |
Total Submitted Charge Amount |
245057 |
Total Medicare Allowed Amount |
151859.77 |
Total Medicare Payment Amount |
108646.77 |
Total Medicare Standardized Payment Amount |
102163.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
97 |
Number Of Medicare Beneficiaries With Drug Services |
78 |
Total Drug Submitted ChargeAmount |
4300 |
Total Drug Medicare AllowedAmount |
1471.68 |
Total Drug Medicare PaymentAmount |
1415.1 |
Total Drug Medicare Standardized Payment Amount |
1415.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
1565 |
Number Of Medicare Beneficiaries With Medical Services |
263 |
Total Medical Submitted Charge Amount |
240757 |
Total Medical Medicare Allowed Amount |
150388.09 |
Total Medical Medicare Payment Amount |
107231.67 |
Total Medical Medicare Standardized Payment Amount |
100747.91 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
99 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
164 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
216 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
16 |
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
221 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.7739 |