National Provider Identifier [NPI]: |
1639124985 |
Last Name Of The Provider |
SZWAJKUN |
First Name Of The Provider |
ROSTYSLAV |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2701 W 68TH ST |
Street Address 2 Of The Provider |
HOLY CROSS HOSPITAL, PHYSICIAN PAVILION, 3RD FLOOR |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606291813 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
210 |
Number Of Medicare Beneficiaries |
186 |
Total Submitted Charge Amount |
106544.8 |
Total Medicare Allowed Amount |
26041.19 |
Total Medicare Payment Amount |
18444.75 |
Total Medicare Standardized Payment Amount |
17020.51 |
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 |
12 |
Number Of Medical Services |
210 |
Number Of Medicare Beneficiaries With Medical Services |
186 |
Total Medical Submitted Charge Amount |
106544.8 |
Total Medical Medicare Allowed Amount |
26041.19 |
Total Medical Medicare Payment Amount |
18444.75 |
Total Medical Medicare Standardized Payment Amount |
17020.51 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
35 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
102 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
37 |
Number Of Black or African American Beneficiaries |
121 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
50 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
136 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
33 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.8054 |