| National Provider Identifier [NPI]: | 1477509537 |
| Last Name Of The Provider | ABEJO |
| First Name Of The Provider | RITA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1044 N FRANCISCO AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606222743 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 145 |
| Number Of Services | 4341 |
| Number Of Medicare Beneficiaries | 2229 |
| Total Submitted Charge Amount | 763475 |
| Total Medicare Allowed Amount | 128991.55 |
| Total Medicare Payment Amount | 94893.17 |
| Total Medicare Standardized Payment Amount | 89158.58 |
| 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 | 145 |
| Number Of Medical Services | 4341 |
| Number Of Medicare Beneficiaries With Medical Services | 2229 |
| Total Medical Submitted Charge Amount | 763475 |
| Total Medical Medicare Allowed Amount | 128991.55 |
| Total Medical Medicare Payment Amount | 94893.17 |
| Total Medical Medicare Standardized Payment Amount | 89158.58 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 299 |
| Number Of Beneficiaries Age 65 to 74 | 718 |
| Number Of Beneficiaries Age 75 to 84 | 695 |
| Number Of Beneficiaries Age Greater 84 | 517 |
| Number Of Female Beneficiaries | 1340 |
| Number Of Male Beneficiaries | 889 |
| Number Of Non Hispanic White Beneficiaries | 1480 |
| Number Of Black or African American Beneficiaries | 334 |
| Number Of AsianPacific Islander Beneficiaries | 39 |
| Number Of Hispanic Beneficiaries | 358 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1571 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 658 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.767 |