National Provider Identifier [NPI]: |
1013013119 |
Last Name Of The Provider |
O'ROURKE |
First Name Of The Provider |
WILLIAM |
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 |
183 N ADDISON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ELMHURST |
Zip Code Of The Provider |
601262748 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
1477 |
Number Of Medicare Beneficiaries |
436 |
Total Submitted Charge Amount |
189295 |
Total Medicare Allowed Amount |
132695.37 |
Total Medicare Payment Amount |
92734.58 |
Total Medicare Standardized Payment Amount |
88723.78 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
159 |
Number Of Beneficiaries Age 75 to 84 |
157 |
Number Of Beneficiaries Age Greater 84 |
93 |
Number Of Female Beneficiaries |
211 |
Number Of Male Beneficiaries |
225 |
Number Of Non Hispanic White Beneficiaries |
409 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
409 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.3981 |