National Provider Identifier [NPI]: |
1043268329 |
Last Name Of The Provider |
SEO |
First Name Of The Provider |
ROBERT |
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 |
1259 RICKERT DR |
Street Address 2 Of The Provider |
STE 200 |
City Of The Provider |
NAPERVILLE |
Zip Code Of The Provider |
605408904 |
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 |
87 |
Number Of Services |
2789 |
Number Of Medicare Beneficiaries |
532 |
Total Submitted Charge Amount |
619006 |
Total Medicare Allowed Amount |
209731.2 |
Total Medicare Payment Amount |
158759.84 |
Total Medicare Standardized Payment Amount |
151281.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
456 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
116571 |
Total Drug Medicare AllowedAmount |
28040.29 |
Total Drug Medicare PaymentAmount |
21983.72 |
Total Drug Medicare Standardized Payment Amount |
21983.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
2333 |
Number Of Medicare Beneficiaries With Medical Services |
532 |
Total Medical Submitted Charge Amount |
502435 |
Total Medical Medicare Allowed Amount |
181690.91 |
Total Medical Medicare Payment Amount |
136776.12 |
Total Medical Medicare Standardized Payment Amount |
129297.56 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
232 |
Number Of Beneficiaries Age 75 to 84 |
193 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
129 |
Number Of Male Beneficiaries |
403 |
Number Of Non Hispanic White Beneficiaries |
453 |
Number Of Black or African American Beneficiaries |
27 |
Number Of AsianPacific Islander Beneficiaries |
25 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
473 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
59 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
25 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4648 |