National Provider Identifier [NPI]: |
1811261753 |
Last Name Of The Provider |
BORKOWSKI |
First Name Of The Provider |
NATALIE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
R.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2003 W FULTON ST |
Street Address 2 Of The Provider |
STE 105 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606122345 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Registered Dietician/Nutrition Professional |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
3 |
Number Of Services |
4151 |
Number Of Medicare Beneficiaries |
512 |
Total Submitted Charge Amount |
285329.52 |
Total Medicare Allowed Amount |
119499.28 |
Total Medicare Payment Amount |
117108.42 |
Total Medicare Standardized Payment Amount |
55680.65 |
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 |
3 |
Number Of Medical Services |
4151 |
Number Of Medicare Beneficiaries With Medical Services |
512 |
Total Medical Submitted Charge Amount |
285329.52 |
Total Medical Medicare Allowed Amount |
119499.28 |
Total Medical Medicare Payment Amount |
117108.42 |
Total Medical Medicare Standardized Payment Amount |
55680.65 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
114 |
Number Of Beneficiaries Age 65 to 74 |
194 |
Number Of Beneficiaries Age 75 to 84 |
149 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
336 |
Number Of Male Beneficiaries |
176 |
Number Of Non Hispanic White Beneficiaries |
135 |
Number Of Black or African American Beneficiaries |
346 |
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 |
243 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
269 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
26 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
62 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.3936 |