| National Provider Identifier [NPI]: | 1932473824 |
| Last Name Of The Provider | RYAN |
| First Name Of The Provider | DIANE |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M,D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1700 W VAN BUREN ST |
| Street Address 2 Of The Provider | SUITE 500 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606125500 |
| 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 | 26 |
| Number Of Services | 813 |
| Number Of Medicare Beneficiaries | 269 |
| Total Submitted Charge Amount | 125882.96 |
| Total Medicare Allowed Amount | 71003 |
| Total Medicare Payment Amount | 51904.07 |
| Total Medicare Standardized Payment Amount | 49364.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 78 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 5979 |
| Total Drug Medicare AllowedAmount | 3018.75 |
| Total Drug Medicare PaymentAmount | 2945.4 |
| Total Drug Medicare Standardized Payment Amount | 2945.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 735 |
| Number Of Medicare Beneficiaries With Medical Services | 269 |
| Total Medical Submitted Charge Amount | 119903.96 |
| Total Medical Medicare Allowed Amount | 67984.25 |
| Total Medical Medicare Payment Amount | 48958.67 |
| Total Medical Medicare Standardized Payment Amount | 46419.18 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 98 |
| Number Of Beneficiaries Age 75 to 84 | 56 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 181 |
| Number Of Male Beneficiaries | 88 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 175 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 49 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 116 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 153 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.8775 |