| National Provider Identifier [NPI]: | 1790790657 |
| Last Name Of The Provider | MAGNO |
| First Name Of The Provider | FAUSTO |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8315 VIRGINIA ST |
| Street Address 2 Of The Provider | STE M |
| City Of The Provider | MERRILLVILLE |
| Zip Code Of The Provider | 464109201 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 496 |
| Number Of Medicare Beneficiaries | 251 |
| Total Submitted Charge Amount | 67163 |
| Total Medicare Allowed Amount | 38249.16 |
| Total Medicare Payment Amount | 24644.79 |
| Total Medicare Standardized Payment Amount | 26647.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 38 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 1122 |
| Total Drug Medicare AllowedAmount | 185.05 |
| Total Drug Medicare PaymentAmount | 178.14 |
| Total Drug Medicare Standardized Payment Amount | 178.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 458 |
| Number Of Medicare Beneficiaries With Medical Services | 251 |
| Total Medical Submitted Charge Amount | 66041 |
| Total Medical Medicare Allowed Amount | 38064.11 |
| Total Medical Medicare Payment Amount | 24466.65 |
| Total Medical Medicare Standardized Payment Amount | 26469.54 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 147 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 156 |
| Number Of Male Beneficiaries | 95 |
| Number Of Non Hispanic White Beneficiaries | 209 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 232 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8712 |