National Provider Identifier [NPI]: |
1710963749 |
Last Name Of The Provider |
BECK |
First Name Of The Provider |
TRACI |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
836 W WELLINGTON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606575147 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
703 |
Number Of Medicare Beneficiaries |
169 |
Total Submitted Charge Amount |
106525 |
Total Medicare Allowed Amount |
41588.6 |
Total Medicare Payment Amount |
32391.36 |
Total Medicare Standardized Payment Amount |
31867.52 |
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 |
68 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
100 |
Number Of Male Beneficiaries |
69 |
Number Of Non Hispanic White Beneficiaries |
49 |
Number Of Black or African American Beneficiaries |
79 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
90 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.1989 |