National Provider Identifier [NPI]: |
1275872558 |
Last Name Of The Provider |
SAMIKKANNU |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2100 PFINGSTEN RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GLENVIEW |
Zip Code Of The Provider |
600261301 |
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 |
19 |
Number Of Services |
1673 |
Number Of Medicare Beneficiaries |
602 |
Total Submitted Charge Amount |
369351 |
Total Medicare Allowed Amount |
185961.66 |
Total Medicare Payment Amount |
143398.38 |
Total Medicare Standardized Payment Amount |
134804.82 |
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 |
1673 |
Number Of Medicare Beneficiaries With Medical Services |
602 |
Total Medical Submitted Charge Amount |
369351 |
Total Medical Medicare Allowed Amount |
185961.66 |
Total Medical Medicare Payment Amount |
143398.38 |
Total Medical Medicare Standardized Payment Amount |
134804.82 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
194 |
Number Of Beneficiaries Age Greater 84 |
220 |
Number Of Female Beneficiaries |
344 |
Number Of Male Beneficiaries |
258 |
Number Of Non Hispanic White Beneficiaries |
554 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
21 |
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 |
514 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
88 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.0648 |