| National Provider Identifier [NPI]: | 1851344568 |
| Last Name Of The Provider | STAMOS |
| First Name Of The Provider | VAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2401 RAVINE WAY |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | GLENVIEW |
| Zip Code Of The Provider | 600257645 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 7955 |
| Number Of Medicare Beneficiaries | 1018 |
| Total Submitted Charge Amount | 2156239 |
| Total Medicare Allowed Amount | 699373.81 |
| Total Medicare Payment Amount | 530593.04 |
| Total Medicare Standardized Payment Amount | 485027.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2318 |
| Number Of Medicare Beneficiaries With Drug Services | 323 |
| Total Drug Submitted ChargeAmount | 85364 |
| Total Drug Medicare AllowedAmount | 63336.02 |
| Total Drug Medicare PaymentAmount | 49323.66 |
| Total Drug Medicare Standardized Payment Amount | 49323.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 5637 |
| Number Of Medicare Beneficiaries With Medical Services | 1018 |
| Total Medical Submitted Charge Amount | 2070875 |
| Total Medical Medicare Allowed Amount | 636037.79 |
| Total Medical Medicare Payment Amount | 481269.38 |
| Total Medical Medicare Standardized Payment Amount | 435704.23 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 401 |
| Number Of Beneficiaries Age 75 to 84 | 429 |
| Number Of Beneficiaries Age Greater 84 | 172 |
| Number Of Female Beneficiaries | 707 |
| Number Of Male Beneficiaries | 311 |
| Number Of Non Hispanic White Beneficiaries | 974 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| 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 | 994 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9675 |