National Provider Identifier [NPI]: |
1831186113 |
Last Name Of The Provider |
RAO |
First Name Of The Provider |
SUBBA |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
17850 KEDZIE |
Street Address 2 Of The Provider |
SUITE 3000 |
City Of The Provider |
HAZEL CREST |
Zip Code Of The Provider |
604292058 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Thoracic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
601 |
Number Of Medicare Beneficiaries |
236 |
Total Submitted Charge Amount |
362710 |
Total Medicare Allowed Amount |
184076.11 |
Total Medicare Payment Amount |
144315.18 |
Total Medicare Standardized Payment Amount |
128225.64 |
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 |
53 |
Number Of Medical Services |
601 |
Number Of Medicare Beneficiaries With Medical Services |
236 |
Total Medical Submitted Charge Amount |
362710 |
Total Medical Medicare Allowed Amount |
184076.11 |
Total Medical Medicare Payment Amount |
144315.18 |
Total Medical Medicare Standardized Payment Amount |
128225.64 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
91 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
137 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
47 |
Number Of Black or African American Beneficiaries |
164 |
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 |
85 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
151 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
24 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
63 |
Percent Of With Chronic Kidney Disease |
71 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
72 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
4.923 |