National Provider Identifier [NPI]: |
1598806929 |
Last Name Of The Provider |
WITTKOPF |
First Name Of The Provider |
MARIA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
880 W CENTRAL RD |
Street Address 2 Of The Provider |
SUITE 7200 |
City Of The Provider |
ARLINGTON HEIGHTS |
Zip Code Of The Provider |
600052355 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
2615 |
Number Of Medicare Beneficiaries |
590 |
Total Submitted Charge Amount |
371989.5 |
Total Medicare Allowed Amount |
147795.03 |
Total Medicare Payment Amount |
110054.29 |
Total Medicare Standardized Payment Amount |
102859.23 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
214 |
Number Of Beneficiaries Age 75 to 84 |
189 |
Number Of Beneficiaries Age Greater 84 |
147 |
Number Of Female Beneficiaries |
347 |
Number Of Male Beneficiaries |
243 |
Number Of Non Hispanic White Beneficiaries |
557 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
535 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
55 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1528 |