National Provider Identifier [NPI]: |
1730245945 |
Last Name Of The Provider |
LUO |
First Name Of The Provider |
XUNRONG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
675 N SAINT CLAIR ST |
Street Address 2 Of The Provider |
GALTER, SUITE 18-250 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606115975 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
596 |
Number Of Medicare Beneficiaries |
245 |
Total Submitted Charge Amount |
209587 |
Total Medicare Allowed Amount |
64193.38 |
Total Medicare Payment Amount |
48487.74 |
Total Medicare Standardized Payment Amount |
46554.8 |
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 |
14 |
Number Of Medical Services |
596 |
Number Of Medicare Beneficiaries With Medical Services |
245 |
Total Medical Submitted Charge Amount |
209587 |
Total Medical Medicare Allowed Amount |
64193.38 |
Total Medical Medicare Payment Amount |
48487.74 |
Total Medical Medicare Standardized Payment Amount |
46554.8 |
Average Age Of Beneficiaries |
56 |
Number Of Beneficiaries Age Less65 |
170 |
Number Of Beneficiaries Age 65 to 74 |
64 |
Number Of Beneficiaries Age 75 to 84 |
11 |
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
100 |
Number Of Male Beneficiaries |
145 |
Number Of Non Hispanic White Beneficiaries |
119 |
Number Of Black or African American Beneficiaries |
64 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
40 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
142 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
65 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
22 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
4.3523 |