National Provider Identifier [NPI]: |
1053438507 |
Last Name Of The Provider |
MATHEW |
First Name Of The Provider |
VINITA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
27650 FERRY RD |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
WARRENVILLE |
Zip Code Of The Provider |
605553845 |
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 |
60 |
Number Of Services |
1540 |
Number Of Medicare Beneficiaries |
327 |
Total Submitted Charge Amount |
665821 |
Total Medicare Allowed Amount |
122705.32 |
Total Medicare Payment Amount |
91917.78 |
Total Medicare Standardized Payment Amount |
86516.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
251 |
Number Of Medicare Beneficiaries With Drug Services |
63 |
Total Drug Submitted ChargeAmount |
4737 |
Total Drug Medicare AllowedAmount |
1747.3 |
Total Drug Medicare PaymentAmount |
1369.98 |
Total Drug Medicare Standardized Payment Amount |
1369.98 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
1289 |
Number Of Medicare Beneficiaries With Medical Services |
327 |
Total Medical Submitted Charge Amount |
661084 |
Total Medical Medicare Allowed Amount |
120958.02 |
Total Medical Medicare Payment Amount |
90547.8 |
Total Medical Medicare Standardized Payment Amount |
85146.61 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
165 |
Number Of Beneficiaries Age 75 to 84 |
99 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
206 |
Number Of Male Beneficiaries |
121 |
Number Of Non Hispanic White Beneficiaries |
299 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
304 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
69 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9738 |