National Provider Identifier [NPI]: |
1326017625 |
Last Name Of The Provider |
HURLEY |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4501 N WINCHESTER AVE |
Street Address 2 Of The Provider |
2ND FL |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
60640 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
1194 |
Number Of Medicare Beneficiaries |
331 |
Total Submitted Charge Amount |
566873 |
Total Medicare Allowed Amount |
129934.49 |
Total Medicare Payment Amount |
99385 |
Total Medicare Standardized Payment Amount |
78145.41 |
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 |
40 |
Number Of Medical Services |
1194 |
Number Of Medicare Beneficiaries With Medical Services |
331 |
Total Medical Submitted Charge Amount |
566873 |
Total Medical Medicare Allowed Amount |
129934.49 |
Total Medical Medicare Payment Amount |
99385 |
Total Medical Medicare Standardized Payment Amount |
78145.41 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
129 |
Number Of Beneficiaries Age 75 to 84 |
115 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
208 |
Number Of Male Beneficiaries |
123 |
Number Of Non Hispanic White Beneficiaries |
291 |
Number Of Black or African American Beneficiaries |
16 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
288 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.2825 |