National Provider Identifier [NPI]: |
1003870387 |
Last Name Of The Provider |
PANAGOS |
First Name Of The Provider |
ELIZABETH |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2320 HIGH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BLUE ISLAND |
Zip Code Of The Provider |
604062426 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
111 |
Number Of Services |
3993 |
Number Of Medicare Beneficiaries |
296 |
Total Submitted Charge Amount |
251314 |
Total Medicare Allowed Amount |
117008.7 |
Total Medicare Payment Amount |
84909.29 |
Total Medicare Standardized Payment Amount |
81587.19 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
736 |
Number Of Medicare Beneficiaries With Drug Services |
75 |
Total Drug Submitted ChargeAmount |
5265 |
Total Drug Medicare AllowedAmount |
2450.08 |
Total Drug Medicare PaymentAmount |
2337.9 |
Total Drug Medicare Standardized Payment Amount |
2337.9 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
105 |
Number Of Medical Services |
3257 |
Number Of Medicare Beneficiaries With Medical Services |
296 |
Total Medical Submitted Charge Amount |
246049 |
Total Medical Medicare Allowed Amount |
114558.62 |
Total Medical Medicare Payment Amount |
82571.39 |
Total Medical Medicare Standardized Payment Amount |
79249.29 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
133 |
Number Of Beneficiaries Age 75 to 84 |
89 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
220 |
Number Of Male Beneficiaries |
76 |
Number Of Non Hispanic White Beneficiaries |
134 |
Number Of Black or African American Beneficiaries |
119 |
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 |
244 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0014 |