National Provider Identifier [NPI]: |
1386619518 |
Last Name Of The Provider |
SHVARTSMAN |
First Name Of The Provider |
YURI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
CALIFORNIA DEVON MEDICAL CENTER |
Street Address 2 Of The Provider |
6420 N. CALIFORNIA AVE. |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
60645 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
2057 |
Number Of Medicare Beneficiaries |
979 |
Total Submitted Charge Amount |
519010 |
Total Medicare Allowed Amount |
262137.69 |
Total Medicare Payment Amount |
205085.79 |
Total Medicare Standardized Payment Amount |
195220.5 |
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 |
12 |
Number Of Medical Services |
2057 |
Number Of Medicare Beneficiaries With Medical Services |
979 |
Total Medical Submitted Charge Amount |
519010 |
Total Medical Medicare Allowed Amount |
262137.69 |
Total Medical Medicare Payment Amount |
205085.79 |
Total Medical Medicare Standardized Payment Amount |
195220.5 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
183 |
Number Of Beneficiaries Age 65 to 74 |
181 |
Number Of Beneficiaries Age 75 to 84 |
255 |
Number Of Beneficiaries Age Greater 84 |
360 |
Number Of Female Beneficiaries |
606 |
Number Of Male Beneficiaries |
373 |
Number Of Non Hispanic White Beneficiaries |
767 |
Number Of Black or African American Beneficiaries |
84 |
Number Of AsianPacific Islander Beneficiaries |
40 |
Number Of Hispanic Beneficiaries |
77 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
369 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
610 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
64 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
72 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
37 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.4336 |