National Provider Identifier [NPI]: |
1851483119 |
Last Name Of The Provider |
STRIEDINGER |
First Name Of The Provider |
FERNANDO |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4733 N DAMEN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606251442 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
4679 |
Number Of Medicare Beneficiaries |
341 |
Total Submitted Charge Amount |
630700 |
Total Medicare Allowed Amount |
365995.09 |
Total Medicare Payment Amount |
266928.83 |
Total Medicare Standardized Payment Amount |
261090.35 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
450 |
Number Of Medicare Beneficiaries With Drug Services |
191 |
Total Drug Submitted ChargeAmount |
34915 |
Total Drug Medicare AllowedAmount |
16236.84 |
Total Drug Medicare PaymentAmount |
12345.55 |
Total Drug Medicare Standardized Payment Amount |
12345.55 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
52 |
Number Of Medical Services |
4229 |
Number Of Medicare Beneficiaries With Medical Services |
341 |
Total Medical Submitted Charge Amount |
595785 |
Total Medical Medicare Allowed Amount |
349758.25 |
Total Medical Medicare Payment Amount |
254583.28 |
Total Medical Medicare Standardized Payment Amount |
248744.8 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
203 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
302 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
127 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
214 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.194 |