National Provider Identifier [NPI]: |
1609866433 |
Last Name Of The Provider |
BORNSTEIN |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9630 KENTON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SKOKIE |
Zip Code Of The Provider |
600761216 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
3130 |
Number Of Medicare Beneficiaries |
1122 |
Total Submitted Charge Amount |
661390 |
Total Medicare Allowed Amount |
379196.42 |
Total Medicare Payment Amount |
271612.42 |
Total Medicare Standardized Payment Amount |
253597.05 |
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 |
26 |
Number Of Medical Services |
3130 |
Number Of Medicare Beneficiaries With Medical Services |
1122 |
Total Medical Submitted Charge Amount |
661390 |
Total Medical Medicare Allowed Amount |
379196.42 |
Total Medical Medicare Payment Amount |
271612.42 |
Total Medical Medicare Standardized Payment Amount |
253597.05 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
513 |
Number Of Beneficiaries Age 75 to 84 |
408 |
Number Of Beneficiaries Age Greater 84 |
180 |
Number Of Female Beneficiaries |
672 |
Number Of Male Beneficiaries |
450 |
Number Of Non Hispanic White Beneficiaries |
1020 |
Number Of Black or African American Beneficiaries |
20 |
Number Of AsianPacific Islander Beneficiaries |
37 |
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
24 |
Number Of Beneficiaries With Medicare Only Entitlement |
1089 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9665 |