National Provider Identifier [NPI]: |
1457503682 |
Last Name Of The Provider |
YORK |
First Name Of The Provider |
SLOANE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1645 W JACKSON BLVD |
Street Address 2 Of The Provider |
SUITE 310 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606123276 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
560 |
Number Of Medicare Beneficiaries |
55 |
Total Submitted Charge Amount |
30752.61 |
Total Medicare Allowed Amount |
8737.75 |
Total Medicare Payment Amount |
6453.53 |
Total Medicare Standardized Payment Amount |
6085.68 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
49 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
55 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
38 |
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
11 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
24 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
42 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.8383 |