| National Provider Identifier [NPI]: | 1740459403 |
| Last Name Of The Provider | VIRASCH |
| First Name Of The Provider | VANEE |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1725 W HARRISON ST |
| Street Address 2 Of The Provider | #918 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606123841 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 1312 |
| Number Of Medicare Beneficiaries | 706 |
| Total Submitted Charge Amount | 851407.5 |
| Total Medicare Allowed Amount | 254224.44 |
| Total Medicare Payment Amount | 187220.48 |
| Total Medicare Standardized Payment Amount | 173456.12 |
| 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 | 53 |
| Number Of Medical Services | 1312 |
| Number Of Medicare Beneficiaries With Medical Services | 706 |
| Total Medical Submitted Charge Amount | 851407.5 |
| Total Medical Medicare Allowed Amount | 254224.44 |
| Total Medical Medicare Payment Amount | 187220.48 |
| Total Medical Medicare Standardized Payment Amount | 173456.12 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 307 |
| Number Of Beneficiaries Age 75 to 84 | 227 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 448 |
| Number Of Male Beneficiaries | 258 |
| Number Of Non Hispanic White Beneficiaries | 384 |
| Number Of Black or African American Beneficiaries | 201 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 79 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 542 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 164 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2649 |