National Provider Identifier [NPI]: |
1306016464 |
Last Name Of The Provider |
THANT |
First Name Of The Provider |
RONALD |
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 |
600 N DEARBORN ST APT 1705 |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606106296 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
199 |
Number Of Services |
22954 |
Number Of Medicare Beneficiaries |
4453 |
Total Submitted Charge Amount |
1654843.8 |
Total Medicare Allowed Amount |
373266.74 |
Total Medicare Payment Amount |
279787.63 |
Total Medicare Standardized Payment Amount |
270904.02 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
16708 |
Number Of Medicare Beneficiaries With Drug Services |
220 |
Total Drug Submitted ChargeAmount |
16923 |
Total Drug Medicare AllowedAmount |
3747.8 |
Total Drug Medicare PaymentAmount |
2936.59 |
Total Drug Medicare Standardized Payment Amount |
2936.59 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
191 |
Number Of Medical Services |
6246 |
Number Of Medicare Beneficiaries With Medical Services |
4453 |
Total Medical Submitted Charge Amount |
1637920.8 |
Total Medical Medicare Allowed Amount |
369518.94 |
Total Medical Medicare Payment Amount |
276851.04 |
Total Medical Medicare Standardized Payment Amount |
267967.43 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
789 |
Number Of Beneficiaries Age 65 to 74 |
1606 |
Number Of Beneficiaries Age 75 to 84 |
1277 |
Number Of Beneficiaries Age Greater 84 |
781 |
Number Of Female Beneficiaries |
2597 |
Number Of Male Beneficiaries |
1856 |
Number Of Non Hispanic White Beneficiaries |
2683 |
Number Of Black or African American Beneficiaries |
267 |
Number Of AsianPacific Islander Beneficiaries |
298 |
Number Of Hispanic Beneficiaries |
1129 |
Number Of American Indian Alaska Native Beneficiaries |
40 |
Number Of Beneficiaries With Race Not Else where Classified |
36 |
Number Of Beneficiaries With Medicare Only Entitlement |
2506 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1947 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.9658 |