National Provider Identifier [NPI]: |
1104951250 |
Last Name Of The Provider |
MIHAILESCU |
First Name Of The Provider |
DAN |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1819 W POLK ST |
Street Address 2 Of The Provider |
SECTION OF ENDOCRINOLOGY (MC 640) |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606124356 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
366 |
Number Of Medicare Beneficiaries |
247 |
Total Submitted Charge Amount |
92940 |
Total Medicare Allowed Amount |
31443.12 |
Total Medicare Payment Amount |
23394.97 |
Total Medicare Standardized Payment Amount |
21691.73 |
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 |
366 |
Number Of Medicare Beneficiaries With Medical Services |
247 |
Total Medical Submitted Charge Amount |
92940 |
Total Medical Medicare Allowed Amount |
31443.12 |
Total Medical Medicare Payment Amount |
23394.97 |
Total Medical Medicare Standardized Payment Amount |
21691.73 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
164 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
39 |
Number Of Black or African American Beneficiaries |
125 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
69 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
82 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
165 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
66 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
25 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.9155 |