| National Provider Identifier [NPI]: | 1386933877 |
| Last Name Of The Provider | CAGA-ANAN |
| First Name Of The Provider | REXANNE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 751 N RUTLEDGE ST |
| Street Address 2 Of The Provider | SUITE 1100 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 62702 |
| 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 | 28 |
| Number Of Services | 374 |
| Number Of Medicare Beneficiaries | 191 |
| Total Submitted Charge Amount | 48762 |
| Total Medicare Allowed Amount | 28721.83 |
| Total Medicare Payment Amount | 22464.19 |
| Total Medicare Standardized Payment Amount | 23397.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 54 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 5934 |
| Total Drug Medicare AllowedAmount | 3491.94 |
| Total Drug Medicare PaymentAmount | 3401.01 |
| Total Drug Medicare Standardized Payment Amount | 3401.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 320 |
| Number Of Medicare Beneficiaries With Medical Services | 191 |
| Total Medical Submitted Charge Amount | 42828 |
| Total Medical Medicare Allowed Amount | 25229.89 |
| Total Medical Medicare Payment Amount | 19063.18 |
| Total Medical Medicare Standardized Payment Amount | 19996.11 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 72 |
| Number Of Beneficiaries Age 75 to 84 | 44 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 122 |
| Number Of Male Beneficiaries | 69 |
| Number Of Non Hispanic White Beneficiaries | 163 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 124 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.6854 |