National Provider Identifier [NPI]: |
1962445304 |
Last Name Of The Provider |
HILL |
First Name Of The Provider |
PETER |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2835 N SHEFFIELD AVE |
Street Address 2 Of The Provider |
SUITE 301 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606575081 |
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 |
25 |
Number Of Services |
629 |
Number Of Medicare Beneficiaries |
191 |
Total Submitted Charge Amount |
109456 |
Total Medicare Allowed Amount |
44361.51 |
Total Medicare Payment Amount |
30456.85 |
Total Medicare Standardized Payment Amount |
28862.85 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
78 |
Number Of Medicare Beneficiaries With Drug Services |
53 |
Total Drug Submitted ChargeAmount |
8847 |
Total Drug Medicare AllowedAmount |
4702.17 |
Total Drug Medicare PaymentAmount |
4595.21 |
Total Drug Medicare Standardized Payment Amount |
4595.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
551 |
Number Of Medicare Beneficiaries With Medical Services |
191 |
Total Medical Submitted Charge Amount |
100609 |
Total Medical Medicare Allowed Amount |
39659.34 |
Total Medical Medicare Payment Amount |
25861.64 |
Total Medical Medicare Standardized Payment Amount |
24267.64 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
111 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
78 |
Number Of Male Beneficiaries |
113 |
Number Of Non Hispanic White Beneficiaries |
135 |
Number Of Black or African American Beneficiaries |
27 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
162 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
30 |
Percent Of With Hypertension |
43 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8954 |