| National Provider Identifier [NPI]: | 1568792620 |
| Last Name Of The Provider | DINNER |
| First Name Of The Provider | SHIRA |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 303 E SUPERIOR ST |
| Street Address 2 Of The Provider | LURIE 5-131 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606113015 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 11447 |
| Number Of Medicare Beneficiaries | 230 |
| Total Submitted Charge Amount | 1680146 |
| Total Medicare Allowed Amount | 422681.49 |
| Total Medicare Payment Amount | 323764.59 |
| Total Medicare Standardized Payment Amount | 320267.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 52 |
| Number Of Drug Services | 9920 |
| Number Of Medicare Beneficiaries With Drug Services | 99 |
| Total Drug Submitted ChargeAmount | 1347042 |
| Total Drug Medicare AllowedAmount | 338705.99 |
| Total Drug Medicare PaymentAmount | 257450.97 |
| Total Drug Medicare Standardized Payment Amount | 257450.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 1527 |
| Number Of Medicare Beneficiaries With Medical Services | 230 |
| Total Medical Submitted Charge Amount | 333104 |
| Total Medical Medicare Allowed Amount | 83975.5 |
| Total Medical Medicare Payment Amount | 66313.62 |
| Total Medical Medicare Standardized Payment Amount | 62816.24 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 102 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 114 |
| Number Of Male Beneficiaries | 116 |
| Number Of Non Hispanic White Beneficiaries | 153 |
| Number Of Black or African American Beneficiaries | 45 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 167 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 27 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.9489 |