National Provider Identifier [NPI]: |
1003062589 |
Last Name Of The Provider |
SCHONEBURG |
First Name Of The Provider |
BERNADETTE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
17 25 WEST HARRISON STREET |
Street Address 2 Of The Provider |
PROFESSIONAL BUILDING I SUITE 1106 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
60612 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
835 |
Number Of Medicare Beneficiaries |
357 |
Total Submitted Charge Amount |
147954 |
Total Medicare Allowed Amount |
93350.83 |
Total Medicare Payment Amount |
70505.37 |
Total Medicare Standardized Payment Amount |
65234.55 |
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 |
22 |
Number Of Medical Services |
835 |
Number Of Medicare Beneficiaries With Medical Services |
357 |
Total Medical Submitted Charge Amount |
147954 |
Total Medical Medicare Allowed Amount |
93350.83 |
Total Medical Medicare Payment Amount |
70505.37 |
Total Medical Medicare Standardized Payment Amount |
65234.55 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
121 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
76 |
Number Of Female Beneficiaries |
163 |
Number Of Male Beneficiaries |
194 |
Number Of Non Hispanic White Beneficiaries |
310 |
Number Of Black or African American Beneficiaries |
14 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
306 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
51 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.4972 |