National Provider Identifier [NPI]: |
1376860262 |
Last Name Of The Provider |
CHOUDHRY |
First Name Of The Provider |
SABA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2525 S MICHIGAN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606162315 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
919 |
Number Of Medicare Beneficiaries |
763 |
Total Submitted Charge Amount |
767220.55 |
Total Medicare Allowed Amount |
162507.87 |
Total Medicare Payment Amount |
123013.49 |
Total Medicare Standardized Payment Amount |
113588.47 |
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 |
26 |
Number Of Medical Services |
919 |
Number Of Medicare Beneficiaries With Medical Services |
763 |
Total Medical Submitted Charge Amount |
767220.55 |
Total Medical Medicare Allowed Amount |
162507.87 |
Total Medical Medicare Payment Amount |
123013.49 |
Total Medical Medicare Standardized Payment Amount |
113588.47 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
178 |
Number Of Beneficiaries Age 65 to 74 |
222 |
Number Of Beneficiaries Age 75 to 84 |
205 |
Number Of Beneficiaries Age Greater 84 |
158 |
Number Of Female Beneficiaries |
461 |
Number Of Male Beneficiaries |
302 |
Number Of Non Hispanic White Beneficiaries |
123 |
Number Of Black or African American Beneficiaries |
546 |
Number Of AsianPacific Islander Beneficiaries |
47 |
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 |
261 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
502 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
24 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.4249 |