National Provider Identifier [NPI]: |
1710912365 |
Last Name Of The Provider |
BAHK |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8012 S CRANDON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606171124 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
493 |
Number Of Medicare Beneficiaries |
407 |
Total Submitted Charge Amount |
595217 |
Total Medicare Allowed Amount |
73551.61 |
Total Medicare Payment Amount |
56355.13 |
Total Medicare Standardized Payment Amount |
51659.95 |
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 |
13 |
Number Of Medical Services |
493 |
Number Of Medicare Beneficiaries With Medical Services |
407 |
Total Medical Submitted Charge Amount |
595217 |
Total Medical Medicare Allowed Amount |
73551.61 |
Total Medical Medicare Payment Amount |
56355.13 |
Total Medical Medicare Standardized Payment Amount |
51659.95 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
144 |
Number Of Beneficiaries Age 65 to 74 |
119 |
Number Of Beneficiaries Age 75 to 84 |
101 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
200 |
Number Of Male Beneficiaries |
207 |
Number Of Non Hispanic White Beneficiaries |
33 |
Number Of Black or African American Beneficiaries |
357 |
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 |
99 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
308 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
26 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
55 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
48 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
61 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
68 |
Percent Of With Schizophrenia Other PsychoticDisorders |
33 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.673 |