National Provider Identifier [NPI]: |
1578598157 |
Last Name Of The Provider |
SENSENG |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2545 S KING DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606162441 |
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 |
54 |
Number Of Services |
929 |
Number Of Medicare Beneficiaries |
163 |
Total Submitted Charge Amount |
82396 |
Total Medicare Allowed Amount |
49128.91 |
Total Medicare Payment Amount |
31479.31 |
Total Medicare Standardized Payment Amount |
29946.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
16 |
Number Of Drug Services |
119 |
Number Of Medicare Beneficiaries With Drug Services |
51 |
Total Drug Submitted ChargeAmount |
3331 |
Total Drug Medicare AllowedAmount |
2151.08 |
Total Drug Medicare PaymentAmount |
2050.14 |
Total Drug Medicare Standardized Payment Amount |
2050.14 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
810 |
Number Of Medicare Beneficiaries With Medical Services |
163 |
Total Medical Submitted Charge Amount |
79065 |
Total Medical Medicare Allowed Amount |
46977.83 |
Total Medical Medicare Payment Amount |
29429.17 |
Total Medical Medicare Standardized Payment Amount |
27896.3 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
91 |
Number Of Beneficiaries Age 75 to 84 |
28 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
90 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
27 |
Number Of Black or African American Beneficiaries |
111 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
125 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
10 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1991 |