National Provider Identifier [NPI]: |
1215044722 |
Last Name Of The Provider |
SEGURA |
First Name Of The Provider |
ROBERTO |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
233 E ERIE ST |
Street Address 2 Of The Provider |
SUITE 702 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606112926 |
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 |
29 |
Number Of Services |
2760 |
Number Of Medicare Beneficiaries |
211 |
Total Submitted Charge Amount |
498148 |
Total Medicare Allowed Amount |
196147.75 |
Total Medicare Payment Amount |
148961.06 |
Total Medicare Standardized Payment Amount |
135018.46 |
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 |
2760 |
Number Of Medicare Beneficiaries With Medical Services |
211 |
Total Medical Submitted Charge Amount |
498148 |
Total Medical Medicare Allowed Amount |
196147.75 |
Total Medical Medicare Payment Amount |
148961.06 |
Total Medical Medicare Standardized Payment Amount |
135018.46 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
42 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
130 |
Number Of Male Beneficiaries |
81 |
Number Of Non Hispanic White Beneficiaries |
174 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
186 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0392 |