National Provider Identifier [NPI]: |
1174557243 |
Last Name Of The Provider |
PURDY |
First Name Of The Provider |
LISA |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9977 WOODS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SKOKIE |
Zip Code Of The Provider |
600771057 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
667 |
Number Of Medicare Beneficiaries |
353 |
Total Submitted Charge Amount |
71440 |
Total Medicare Allowed Amount |
52397.54 |
Total Medicare Payment Amount |
37101.76 |
Total Medicare Standardized Payment Amount |
34736.31 |
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 |
8 |
Number Of Medical Services |
667 |
Number Of Medicare Beneficiaries With Medical Services |
353 |
Total Medical Submitted Charge Amount |
71440 |
Total Medical Medicare Allowed Amount |
52397.54 |
Total Medical Medicare Payment Amount |
37101.76 |
Total Medical Medicare Standardized Payment Amount |
34736.31 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
175 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
245 |
Number Of Male Beneficiaries |
108 |
Number Of Non Hispanic White Beneficiaries |
289 |
Number Of Black or African American Beneficiaries |
23 |
Number Of AsianPacific Islander Beneficiaries |
22 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
306 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
74 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4375 |