National Provider Identifier [NPI]: |
1114000999 |
Last Name Of The Provider |
VESKOVIC |
First Name Of The Provider |
KATARINA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5841 S. MARYLAND |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606371447 |
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 |
16 |
Number Of Services |
285 |
Number Of Medicare Beneficiaries |
84 |
Total Submitted Charge Amount |
79898 |
Total Medicare Allowed Amount |
27799.69 |
Total Medicare Payment Amount |
20083.46 |
Total Medicare Standardized Payment Amount |
18721.55 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
26 |
Number Of Medicare Beneficiaries With Drug Services |
16 |
Total Drug Submitted ChargeAmount |
1862 |
Total Drug Medicare AllowedAmount |
489.44 |
Total Drug Medicare PaymentAmount |
376.41 |
Total Drug Medicare Standardized Payment Amount |
376.41 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
259 |
Number Of Medicare Beneficiaries With Medical Services |
84 |
Total Medical Submitted Charge Amount |
78036 |
Total Medical Medicare Allowed Amount |
27310.25 |
Total Medical Medicare Payment Amount |
19707.05 |
Total Medical Medicare Standardized Payment Amount |
18345.14 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
38 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
61 |
Number Of Male Beneficiaries |
23 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
55 |
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 |
46 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4767 |