National Provider Identifier [NPI]: |
1164403317 |
Last Name Of The Provider |
SANCHEZ |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M. D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
75 REMITTANCE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606756508 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
290 |
Number Of Medicare Beneficiaries |
215 |
Total Submitted Charge Amount |
138673 |
Total Medicare Allowed Amount |
38057.59 |
Total Medicare Payment Amount |
27224.23 |
Total Medicare Standardized Payment Amount |
26586.66 |
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 |
16 |
Number Of Medical Services |
290 |
Number Of Medicare Beneficiaries With Medical Services |
215 |
Total Medical Submitted Charge Amount |
138673 |
Total Medical Medicare Allowed Amount |
38057.59 |
Total Medical Medicare Payment Amount |
27224.23 |
Total Medical Medicare Standardized Payment Amount |
26586.66 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
119 |
Number Of Male Beneficiaries |
96 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
150 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.8442 |