National Provider Identifier [NPI]: |
1386636884 |
Last Name Of The Provider |
MALECKI |
First Name Of The Provider |
ZBIGNIEW |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1775 DEMPSTER ST |
Street Address 2 Of The Provider |
LUTHERAN GENERAL HOSPITAL / PATHOLOGY DEPARTMENT |
City Of The Provider |
PARK RIDGE |
Zip Code Of The Provider |
600681143 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
1426 |
Number Of Medicare Beneficiaries |
474 |
Total Submitted Charge Amount |
324063 |
Total Medicare Allowed Amount |
51593.49 |
Total Medicare Payment Amount |
39591.19 |
Total Medicare Standardized Payment Amount |
28636.11 |
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 |
26 |
Number Of Medical Services |
1426 |
Number Of Medicare Beneficiaries With Medical Services |
474 |
Total Medical Submitted Charge Amount |
324063 |
Total Medical Medicare Allowed Amount |
51593.49 |
Total Medical Medicare Payment Amount |
39591.19 |
Total Medical Medicare Standardized Payment Amount |
28636.11 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
89 |
Number Of Beneficiaries Age 65 to 74 |
251 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
279 |
Number Of Male Beneficiaries |
195 |
Number Of Non Hispanic White Beneficiaries |
191 |
Number Of Black or African American Beneficiaries |
128 |
Number Of AsianPacific Islander Beneficiaries |
14 |
Number Of Hispanic Beneficiaries |
124 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
287 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
187 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4075 |