National Provider Identifier [NPI]: |
1649265448 |
Last Name Of The Provider |
KALISH |
First Name Of The Provider |
STEVE |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2740 W FOSTER AVE |
Street Address 2 Of The Provider |
SUITE 214 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606253500 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
1270 |
Number Of Medicare Beneficiaries |
325 |
Total Submitted Charge Amount |
268015 |
Total Medicare Allowed Amount |
152192.81 |
Total Medicare Payment Amount |
118936.31 |
Total Medicare Standardized Payment Amount |
106889.47 |
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 |
15 |
Number Of Medical Services |
1270 |
Number Of Medicare Beneficiaries With Medical Services |
325 |
Total Medical Submitted Charge Amount |
268015 |
Total Medical Medicare Allowed Amount |
152192.81 |
Total Medical Medicare Payment Amount |
118936.31 |
Total Medical Medicare Standardized Payment Amount |
106889.47 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
90 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
63 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
156 |
Number Of Non Hispanic White Beneficiaries |
228 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
31 |
Number Of Hispanic Beneficiaries |
32 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
172 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
153 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
66 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
58 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
3.1842 |