National Provider Identifier [NPI]: |
1336277029 |
Last Name Of The Provider |
MCMANUS |
First Name Of The Provider |
BONNIE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 N BERTEAU AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ELMHURST |
Zip Code Of The Provider |
601262966 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
439 |
Number Of Medicare Beneficiaries |
322 |
Total Submitted Charge Amount |
85983.67 |
Total Medicare Allowed Amount |
33027.47 |
Total Medicare Payment Amount |
23864.24 |
Total Medicare Standardized Payment Amount |
23021.38 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
18 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
4944.67 |
Total Drug Medicare AllowedAmount |
510.67 |
Total Drug Medicare PaymentAmount |
400.38 |
Total Drug Medicare Standardized Payment Amount |
400.38 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
421 |
Number Of Medicare Beneficiaries With Medical Services |
321 |
Total Medical Submitted Charge Amount |
81039 |
Total Medical Medicare Allowed Amount |
32516.8 |
Total Medical Medicare Payment Amount |
23463.86 |
Total Medical Medicare Standardized Payment Amount |
22621 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
142 |
Number Of Beneficiaries Age 75 to 84 |
88 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
218 |
Number Of Male Beneficiaries |
104 |
Number Of Non Hispanic White Beneficiaries |
289 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
276 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9597 |