National Provider Identifier [NPI]: |
1558356253 |
Last Name Of The Provider |
YONOVER |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1011 W WELLINGTON AVE |
Street Address 2 Of The Provider |
STE 200 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606574325 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
83 |
Number Of Services |
6105 |
Number Of Medicare Beneficiaries |
332 |
Total Submitted Charge Amount |
817580 |
Total Medicare Allowed Amount |
210698.97 |
Total Medicare Payment Amount |
157410.92 |
Total Medicare Standardized Payment Amount |
149687.35 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
3319 |
Number Of Medicare Beneficiaries With Drug Services |
16 |
Total Drug Submitted ChargeAmount |
108160 |
Total Drug Medicare AllowedAmount |
30361.98 |
Total Drug Medicare PaymentAmount |
23778.79 |
Total Drug Medicare Standardized Payment Amount |
23778.79 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
78 |
Number Of Medical Services |
2786 |
Number Of Medicare Beneficiaries With Medical Services |
332 |
Total Medical Submitted Charge Amount |
709420 |
Total Medical Medicare Allowed Amount |
180336.99 |
Total Medical Medicare Payment Amount |
133632.13 |
Total Medical Medicare Standardized Payment Amount |
125908.56 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
179 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
45 |
Number Of Male Beneficiaries |
287 |
Number Of Non Hispanic White Beneficiaries |
212 |
Number Of Black or African American Beneficiaries |
62 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
38 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
279 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
27 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.317 |