| National Provider Identifier [NPI]: | 1851338792 |
| Last Name Of The Provider | CONTE-RUSSIAN |
| First Name Of The Provider | AMELIA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3319 N ELSTON AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 60618 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Geriatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 6629 |
| Number Of Medicare Beneficiaries | 574 |
| Total Submitted Charge Amount | 973366 |
| Total Medicare Allowed Amount | 768571.67 |
| Total Medicare Payment Amount | 582898.71 |
| Total Medicare Standardized Payment Amount | 557622.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 75 |
| Number Of Medicare Beneficiaries With Drug Services | 75 |
| Total Drug Submitted ChargeAmount | 2625 |
| Total Drug Medicare AllowedAmount | 891.75 |
| Total Drug Medicare PaymentAmount | 873.75 |
| Total Drug Medicare Standardized Payment Amount | 873.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 6554 |
| Number Of Medicare Beneficiaries With Medical Services | 574 |
| Total Medical Submitted Charge Amount | 970741 |
| Total Medical Medicare Allowed Amount | 767679.92 |
| Total Medical Medicare Payment Amount | 582024.96 |
| Total Medical Medicare Standardized Payment Amount | 556748.53 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 112 |
| Number Of Beneficiaries Age 65 to 74 | 195 |
| Number Of Beneficiaries Age 75 to 84 | 150 |
| Number Of Beneficiaries Age Greater 84 | 117 |
| Number Of Female Beneficiaries | 348 |
| Number Of Male Beneficiaries | 226 |
| Number Of Non Hispanic White Beneficiaries | 107 |
| Number Of Black or African American Beneficiaries | 226 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 199 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 169 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 405 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 22 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 54 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 71 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.4114 |