National Provider Identifier [NPI]: |
1831207174 |
Last Name Of The Provider |
ONG |
First Name Of The Provider |
PIA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5666 EAST STATE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCKFORD |
Zip Code Of The Provider |
611082472 |
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 |
18 |
Number Of Services |
1311 |
Number Of Medicare Beneficiaries |
433 |
Total Submitted Charge Amount |
340620 |
Total Medicare Allowed Amount |
127958.26 |
Total Medicare Payment Amount |
99594.11 |
Total Medicare Standardized Payment Amount |
101408.15 |
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 |
18 |
Number Of Medical Services |
1311 |
Number Of Medicare Beneficiaries With Medical Services |
433 |
Total Medical Submitted Charge Amount |
340620 |
Total Medical Medicare Allowed Amount |
127958.26 |
Total Medical Medicare Payment Amount |
99594.11 |
Total Medical Medicare Standardized Payment Amount |
101408.15 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
79 |
Number Of Beneficiaries Age 65 to 74 |
127 |
Number Of Beneficiaries Age 75 to 84 |
129 |
Number Of Beneficiaries Age Greater 84 |
98 |
Number Of Female Beneficiaries |
246 |
Number Of Male Beneficiaries |
187 |
Number Of Non Hispanic White Beneficiaries |
379 |
Number Of Black or African American Beneficiaries |
26 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
280 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
153 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.3798 |