| National Provider Identifier [NPI]: | 1205932332 |
| Last Name Of The Provider | DRAGISIC |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4201 W 95TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | OAK LAWN |
| Zip Code Of The Provider | 604532615 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 3510 |
| Number Of Medicare Beneficiaries | 474 |
| Total Submitted Charge Amount | 405715 |
| Total Medicare Allowed Amount | 222846.7 |
| Total Medicare Payment Amount | 154326.56 |
| Total Medicare Standardized Payment Amount | 140393.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 372 |
| Number Of Medicare Beneficiaries With Drug Services | 276 |
| Total Drug Submitted ChargeAmount | 14070 |
| Total Drug Medicare AllowedAmount | 7121.32 |
| Total Drug Medicare PaymentAmount | 6721.25 |
| Total Drug Medicare Standardized Payment Amount | 6721.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 3138 |
| Number Of Medicare Beneficiaries With Medical Services | 474 |
| Total Medical Submitted Charge Amount | 391645 |
| Total Medical Medicare Allowed Amount | 215725.38 |
| Total Medical Medicare Payment Amount | 147605.31 |
| Total Medical Medicare Standardized Payment Amount | 133671.85 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 204 |
| Number Of Beneficiaries Age 75 to 84 | 162 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 269 |
| Number Of Male Beneficiaries | 205 |
| Number Of Non Hispanic White Beneficiaries | 429 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 448 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1007 |