National Provider Identifier [NPI]: |
1548260623 |
Last Name Of The Provider |
ORELLANA |
First Name Of The Provider |
FERNANDO |
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 |
1501 S CALIFORNIA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606081732 |
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 |
28 |
Number Of Services |
633 |
Number Of Medicare Beneficiaries |
464 |
Total Submitted Charge Amount |
204789 |
Total Medicare Allowed Amount |
86898.97 |
Total Medicare Payment Amount |
64612.54 |
Total Medicare Standardized Payment Amount |
59281.96 |
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 |
28 |
Number Of Medical Services |
633 |
Number Of Medicare Beneficiaries With Medical Services |
464 |
Total Medical Submitted Charge Amount |
204789 |
Total Medical Medicare Allowed Amount |
86898.97 |
Total Medical Medicare Payment Amount |
64612.54 |
Total Medical Medicare Standardized Payment Amount |
59281.96 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
186 |
Number Of Beneficiaries Age 65 to 74 |
132 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
269 |
Number Of Male Beneficiaries |
195 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
338 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
88 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
93 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
371 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
29 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.4632 |