National Provider Identifier [NPI]: |
1558574319 |
Last Name Of The Provider |
GRUSS |
First Name Of The Provider |
JASON |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4953 N LEAVITT ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606251308 |
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 |
12 |
Number Of Services |
1725 |
Number Of Medicare Beneficiaries |
616 |
Total Submitted Charge Amount |
321927.5 |
Total Medicare Allowed Amount |
195286.12 |
Total Medicare Payment Amount |
152036.84 |
Total Medicare Standardized Payment Amount |
142208.1 |
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 |
12 |
Number Of Medical Services |
1725 |
Number Of Medicare Beneficiaries With Medical Services |
616 |
Total Medical Submitted Charge Amount |
321927.5 |
Total Medical Medicare Allowed Amount |
195286.12 |
Total Medical Medicare Payment Amount |
152036.84 |
Total Medical Medicare Standardized Payment Amount |
142208.1 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
208 |
Number Of Beneficiaries Age Greater 84 |
205 |
Number Of Female Beneficiaries |
367 |
Number Of Male Beneficiaries |
249 |
Number Of Non Hispanic White Beneficiaries |
452 |
Number Of Black or African American Beneficiaries |
110 |
Number Of AsianPacific Islander Beneficiaries |
25 |
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 |
349 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
267 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
53 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
64 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
58 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
66 |
Percent Of With Schizophrenia Other PsychoticDisorders |
23 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
2.7373 |