National Provider Identifier [NPI]: |
1982709879 |
Last Name Of The Provider |
DEANO |
First Name Of The Provider |
DANILO |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2222 W DIVISION ST |
Street Address 2 Of The Provider |
SUITE # 300 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606222717 |
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 |
39 |
Number Of Services |
2988 |
Number Of Medicare Beneficiaries |
1436 |
Total Submitted Charge Amount |
600330 |
Total Medicare Allowed Amount |
171133.6 |
Total Medicare Payment Amount |
129633.25 |
Total Medicare Standardized Payment Amount |
121505.93 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
365 |
Number Of Beneficiaries Age 65 to 74 |
457 |
Number Of Beneficiaries Age 75 to 84 |
411 |
Number Of Beneficiaries Age Greater 84 |
203 |
Number Of Female Beneficiaries |
779 |
Number Of Male Beneficiaries |
657 |
Number Of Non Hispanic White Beneficiaries |
284 |
Number Of Black or African American Beneficiaries |
275 |
Number Of AsianPacific Islander Beneficiaries |
39 |
Number Of Hispanic Beneficiaries |
814 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
401 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1035 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
29 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
63 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.2787 |