National Provider Identifier [NPI]: |
1942268172 |
Last Name Of The Provider |
MACHADO |
First Name Of The Provider |
ROBERTO |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
840 S WOOD ST RM 920-N |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606124325 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
558 |
Number Of Medicare Beneficiaries |
217 |
Total Submitted Charge Amount |
207693 |
Total Medicare Allowed Amount |
69771.59 |
Total Medicare Payment Amount |
53506.11 |
Total Medicare Standardized Payment Amount |
49624.76 |
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 |
29 |
Number Of Medical Services |
558 |
Number Of Medicare Beneficiaries With Medical Services |
217 |
Total Medical Submitted Charge Amount |
207693 |
Total Medical Medicare Allowed Amount |
69771.59 |
Total Medical Medicare Payment Amount |
53506.11 |
Total Medical Medicare Standardized Payment Amount |
49624.76 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
116 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
44 |
Number Of Black or African American Beneficiaries |
121 |
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 |
82 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
135 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
3.1881 |