| National Provider Identifier [NPI]: | 1538134457 |
| Last Name Of The Provider | OLIVEROS |
| First Name Of The Provider | MARIO |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5015 N PAULINA ST |
| Street Address 2 Of The Provider | SUITE 218 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606402756 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 4548 |
| Number Of Medicare Beneficiaries | 326 |
| Total Submitted Charge Amount | 573565 |
| Total Medicare Allowed Amount | 492216.25 |
| Total Medicare Payment Amount | 385879.04 |
| Total Medicare Standardized Payment Amount | 361008.16 |
| 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 | 17 |
| Number Of Medical Services | 4548 |
| Number Of Medicare Beneficiaries With Medical Services | 326 |
| Total Medical Submitted Charge Amount | 573565 |
| Total Medical Medicare Allowed Amount | 492216.25 |
| Total Medical Medicare Payment Amount | 385879.04 |
| Total Medical Medicare Standardized Payment Amount | 361008.16 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 109 |
| Number Of Beneficiaries Age 65 to 74 | 101 |
| Number Of Beneficiaries Age 75 to 84 | 72 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 139 |
| Number Of Male Beneficiaries | 187 |
| Number Of Non Hispanic White Beneficiaries | 116 |
| Number Of Black or African American Beneficiaries | 130 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 66 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 56 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 270 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 51 |
| Percent Of With Asthma | 25 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 70 |
| Percent Of With Chronic Kidney Disease | 65 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 71 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 71 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 45 |
| Percent Of With Stroke | 25 |
| Average HCC Risk Score Of Beneficiaries | 4.1968 |