National Provider Identifier [NPI]: |
1013019728 |
Last Name Of The Provider |
GOH |
First Name Of The Provider |
ANN |
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 |
1700 W VAN BUREN ST |
Street Address 2 Of The Provider |
SUITE 500 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606123218 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
1240 |
Number Of Medicare Beneficiaries |
398 |
Total Submitted Charge Amount |
280253 |
Total Medicare Allowed Amount |
117984.75 |
Total Medicare Payment Amount |
90187.65 |
Total Medicare Standardized Payment Amount |
84989.41 |
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 |
13 |
Number Of Medical Services |
1240 |
Number Of Medicare Beneficiaries With Medical Services |
398 |
Total Medical Submitted Charge Amount |
280253 |
Total Medical Medicare Allowed Amount |
117984.75 |
Total Medical Medicare Payment Amount |
90187.65 |
Total Medical Medicare Standardized Payment Amount |
84989.41 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
155 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
236 |
Number Of Male Beneficiaries |
162 |
Number Of Non Hispanic White Beneficiaries |
150 |
Number Of Black or African American Beneficiaries |
188 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
49 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
201 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
197 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
24 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.8206 |