National Provider Identifier [NPI]: |
1285607341 |
Last Name Of The Provider |
ISAKOW |
First Name Of The Provider |
WARREN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4921 PARKVIEW PL |
Street Address 2 Of The Provider |
STE 8B |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631101032 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Critical Care (Intensivists) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
1062 |
Number Of Medicare Beneficiaries |
286 |
Total Submitted Charge Amount |
651219 |
Total Medicare Allowed Amount |
164114.48 |
Total Medicare Payment Amount |
127965.9 |
Total Medicare Standardized Payment Amount |
128957.51 |
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 |
23 |
Number Of Medical Services |
1062 |
Number Of Medicare Beneficiaries With Medical Services |
286 |
Total Medical Submitted Charge Amount |
651219 |
Total Medical Medicare Allowed Amount |
164114.48 |
Total Medical Medicare Payment Amount |
127965.9 |
Total Medical Medicare Standardized Payment Amount |
128957.51 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
111 |
Number Of Beneficiaries Age 65 to 74 |
91 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
130 |
Number Of Non Hispanic White Beneficiaries |
169 |
Number Of Black or African American Beneficiaries |
|
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 |
162 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
124 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
64 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
49 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
3.5882 |