National Provider Identifier [NPI]: |
1356357651 |
Last Name Of The Provider |
VALENTE |
First Name Of The Provider |
MARTIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
801 S MILWAUKEE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LIBERTYVILLE |
Zip Code Of The Provider |
600483204 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
80 |
Number Of Services |
572 |
Number Of Medicare Beneficiaries |
514 |
Total Submitted Charge Amount |
941845 |
Total Medicare Allowed Amount |
92272.23 |
Total Medicare Payment Amount |
71425.27 |
Total Medicare Standardized Payment Amount |
66431.98 |
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 |
80 |
Number Of Medical Services |
572 |
Number Of Medicare Beneficiaries With Medical Services |
514 |
Total Medical Submitted Charge Amount |
941845 |
Total Medical Medicare Allowed Amount |
92272.23 |
Total Medical Medicare Payment Amount |
71425.27 |
Total Medical Medicare Standardized Payment Amount |
66431.98 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
78 |
Number Of Beneficiaries Age 65 to 74 |
218 |
Number Of Beneficiaries Age 75 to 84 |
163 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
278 |
Number Of Male Beneficiaries |
236 |
Number Of Non Hispanic White Beneficiaries |
394 |
Number Of Black or African American Beneficiaries |
41 |
Number Of AsianPacific Islander Beneficiaries |
18 |
Number Of Hispanic Beneficiaries |
48 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
377 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
137 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.5669 |