National Provider Identifier [NPI]: |
1619993078 |
Last Name Of The Provider |
PATZIK |
First Name Of The Provider |
SHAYLE |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
801 S MILWAUKEE ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LIBERTYVILLE |
Zip Code Of The Provider |
600483199 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
226 |
Number Of Services |
4327 |
Number Of Medicare Beneficiaries |
2284 |
Total Submitted Charge Amount |
927558 |
Total Medicare Allowed Amount |
229423.12 |
Total Medicare Payment Amount |
174783.02 |
Total Medicare Standardized Payment Amount |
164822.56 |
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 |
226 |
Number Of Medical Services |
4327 |
Number Of Medicare Beneficiaries With Medical Services |
2284 |
Total Medical Submitted Charge Amount |
927558 |
Total Medical Medicare Allowed Amount |
229423.12 |
Total Medical Medicare Payment Amount |
174783.02 |
Total Medical Medicare Standardized Payment Amount |
164822.56 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
293 |
Number Of Beneficiaries Age 65 to 74 |
734 |
Number Of Beneficiaries Age 75 to 84 |
752 |
Number Of Beneficiaries Age Greater 84 |
505 |
Number Of Female Beneficiaries |
1337 |
Number Of Male Beneficiaries |
947 |
Number Of Non Hispanic White Beneficiaries |
1921 |
Number Of Black or African American Beneficiaries |
112 |
Number Of AsianPacific Islander Beneficiaries |
55 |
Number Of Hispanic Beneficiaries |
164 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1751 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
533 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.1172 |