National Provider Identifier [NPI]: |
1033126008 |
Last Name Of The Provider |
MERSHON |
First Name Of The Provider |
LYNN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1990 LARKIN AVE |
Street Address 2 Of The Provider |
SUITE 3 |
City Of The Provider |
ELGIN |
Zip Code Of The Provider |
60123 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
799 |
Number Of Medicare Beneficiaries |
445 |
Total Submitted Charge Amount |
119257 |
Total Medicare Allowed Amount |
82826.32 |
Total Medicare Payment Amount |
60794.9 |
Total Medicare Standardized Payment Amount |
57302.45 |
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 |
16 |
Number Of Medical Services |
799 |
Number Of Medicare Beneficiaries With Medical Services |
445 |
Total Medical Submitted Charge Amount |
119257 |
Total Medical Medicare Allowed Amount |
82826.32 |
Total Medical Medicare Payment Amount |
60794.9 |
Total Medical Medicare Standardized Payment Amount |
57302.45 |
Average Age Of Beneficiaries |
81 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
136 |
Number Of Beneficiaries Age Greater 84 |
204 |
Number Of Female Beneficiaries |
287 |
Number Of Male Beneficiaries |
158 |
Number Of Non Hispanic White Beneficiaries |
391 |
Number Of Black or African American Beneficiaries |
32 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
252 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
193 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
60 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
54 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.627 |