National Provider Identifier [NPI]: |
1356332860 |
Last Name Of The Provider |
SIEGEL |
First Name Of The Provider |
AARON |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 S GREENLEAF ST |
Street Address 2 Of The Provider |
STE A |
City Of The Provider |
GURNEE |
Zip Code Of The Provider |
600313370 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
478 |
Number Of Medicare Beneficiaries |
238 |
Total Submitted Charge Amount |
361298.75 |
Total Medicare Allowed Amount |
104715.6 |
Total Medicare Payment Amount |
80672.63 |
Total Medicare Standardized Payment Amount |
73635.05 |
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 |
66 |
Number Of Medical Services |
478 |
Number Of Medicare Beneficiaries With Medical Services |
238 |
Total Medical Submitted Charge Amount |
361298.75 |
Total Medical Medicare Allowed Amount |
104715.6 |
Total Medical Medicare Payment Amount |
80672.63 |
Total Medical Medicare Standardized Payment Amount |
73635.05 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
78 |
Number Of Beneficiaries Age 65 to 74 |
85 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
144 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
140 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
55 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
132 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6934 |