National Provider Identifier [NPI]: |
1164412557 |
Last Name Of The Provider |
AJROUD-DRISS |
First Name Of The Provider |
SENDA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
680 N LAKE SHORE DR |
Street Address 2 Of The Provider |
SUITE 1000 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606114546 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
634 |
Number Of Medicare Beneficiaries |
315 |
Total Submitted Charge Amount |
250598 |
Total Medicare Allowed Amount |
70118.88 |
Total Medicare Payment Amount |
52527.14 |
Total Medicare Standardized Payment Amount |
49720.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
11 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
275 |
Total Drug Medicare AllowedAmount |
120.86 |
Total Drug Medicare PaymentAmount |
118.43 |
Total Drug Medicare Standardized Payment Amount |
118.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
623 |
Number Of Medicare Beneficiaries With Medical Services |
315 |
Total Medical Submitted Charge Amount |
250323 |
Total Medical Medicare Allowed Amount |
69998.02 |
Total Medical Medicare Payment Amount |
52408.71 |
Total Medical Medicare Standardized Payment Amount |
49601.9 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
84 |
Number Of Beneficiaries Age 65 to 74 |
136 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
163 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
231 |
Number Of Black or African American Beneficiaries |
48 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
248 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
67 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.7267 |