| National Provider Identifier [NPI]: | 1831295880 |
| Last Name Of The Provider | ZDUNEK |
| First Name Of The Provider | TERESITA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2900 N LAKE SHORE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606575640 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 1860 |
| Number Of Medicare Beneficiaries | 658 |
| Total Submitted Charge Amount | 250249.7 |
| Total Medicare Allowed Amount | 64883.77 |
| Total Medicare Payment Amount | 50488.46 |
| Total Medicare Standardized Payment Amount | 47095.58 |
| 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 | 44 |
| Number Of Medical Services | 1860 |
| Number Of Medicare Beneficiaries With Medical Services | 658 |
| Total Medical Submitted Charge Amount | 250249.7 |
| Total Medical Medicare Allowed Amount | 64883.77 |
| Total Medical Medicare Payment Amount | 50488.46 |
| Total Medical Medicare Standardized Payment Amount | 47095.58 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 93 |
| Number Of Beneficiaries Age 65 to 74 | 287 |
| Number Of Beneficiaries Age 75 to 84 | 185 |
| Number Of Beneficiaries Age Greater 84 | 93 |
| Number Of Female Beneficiaries | 370 |
| Number Of Male Beneficiaries | 288 |
| Number Of Non Hispanic White Beneficiaries | 413 |
| Number Of Black or African American Beneficiaries | 136 |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | 67 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 470 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 188 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7598 |