National Provider Identifier [NPI]: |
1336136704 |
Last Name Of The Provider |
GRAGASIN |
First Name Of The Provider |
MARIA |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1501 S CALIFORNIA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606081732 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
811 |
Number Of Medicare Beneficiaries |
225 |
Total Submitted Charge Amount |
191015 |
Total Medicare Allowed Amount |
92886.67 |
Total Medicare Payment Amount |
72233.97 |
Total Medicare Standardized Payment Amount |
66873.32 |
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 |
19 |
Number Of Medical Services |
811 |
Number Of Medicare Beneficiaries With Medical Services |
225 |
Total Medical Submitted Charge Amount |
191015 |
Total Medical Medicare Allowed Amount |
92886.67 |
Total Medical Medicare Payment Amount |
72233.97 |
Total Medical Medicare Standardized Payment Amount |
66873.32 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
72 |
Number Of Beneficiaries Age 75 to 84 |
42 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
123 |
Number Of Male Beneficiaries |
102 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
106 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
84 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
51 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
174 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
40 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
61 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
30 |
Percent Of With Stroke |
32 |
Average HCC Risk Score Of Beneficiaries |
2.6516 |