National Provider Identifier [NPI]: |
1275631426 |
Last Name Of The Provider |
MILIK |
First Name Of The Provider |
ADAM |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4854 W COURT ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MONEE |
Zip Code Of The Provider |
604498988 |
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 |
47 |
Number Of Services |
4713 |
Number Of Medicare Beneficiaries |
611 |
Total Submitted Charge Amount |
559995 |
Total Medicare Allowed Amount |
347537.23 |
Total Medicare Payment Amount |
248625.57 |
Total Medicare Standardized Payment Amount |
246376.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
194 |
Number Of Medicare Beneficiaries With Drug Services |
175 |
Total Drug Submitted ChargeAmount |
6695 |
Total Drug Medicare AllowedAmount |
1883.31 |
Total Drug Medicare PaymentAmount |
1827.93 |
Total Drug Medicare Standardized Payment Amount |
1827.93 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
4519 |
Number Of Medicare Beneficiaries With Medical Services |
611 |
Total Medical Submitted Charge Amount |
553300 |
Total Medical Medicare Allowed Amount |
345653.92 |
Total Medical Medicare Payment Amount |
246797.64 |
Total Medical Medicare Standardized Payment Amount |
244549.04 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
219 |
Number Of Beneficiaries Age 75 to 84 |
206 |
Number Of Beneficiaries Age Greater 84 |
94 |
Number Of Female Beneficiaries |
327 |
Number Of Male Beneficiaries |
284 |
Number Of Non Hispanic White Beneficiaries |
540 |
Number Of Black or African American Beneficiaries |
48 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
460 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
151 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.7304 |