National Provider Identifier [NPI]: |
1427279348 |
Last Name Of The Provider |
FISHMAN |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
25 N WINFIELD RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WINFIELD |
Zip Code Of The Provider |
601901295 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
526 |
Number Of Medicare Beneficiaries |
156 |
Total Submitted Charge Amount |
244157 |
Total Medicare Allowed Amount |
86699.61 |
Total Medicare Payment Amount |
66271.57 |
Total Medicare Standardized Payment Amount |
59587.79 |
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 |
59 |
Number Of Medical Services |
526 |
Number Of Medicare Beneficiaries With Medical Services |
156 |
Total Medical Submitted Charge Amount |
244157 |
Total Medical Medicare Allowed Amount |
86699.61 |
Total Medical Medicare Payment Amount |
66271.57 |
Total Medical Medicare Standardized Payment Amount |
59587.79 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
110 |
Number Of Male Beneficiaries |
46 |
Number Of Non Hispanic White Beneficiaries |
138 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
127 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.2666 |