| National Provider Identifier [NPI]: | 1255502506 |
| Last Name Of The Provider | VENUGOPAL |
| First Name Of The Provider | ANILRUDH |
| 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 | 2160 S 1ST AVE |
| Street Address 2 Of The Provider | FAHEY BLDG, ROOM 115 |
| City Of The Provider | MAYWOOD |
| Zip Code Of The Provider | 601533328 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 761 |
| Number Of Medicare Beneficiaries | 249 |
| Total Submitted Charge Amount | 182773 |
| Total Medicare Allowed Amount | 71668.92 |
| Total Medicare Payment Amount | 55953.96 |
| Total Medicare Standardized Payment Amount | 52210.73 |
| 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 | 13 |
| Number Of Medical Services | 761 |
| Number Of Medicare Beneficiaries With Medical Services | 249 |
| Total Medical Submitted Charge Amount | 182773 |
| Total Medical Medicare Allowed Amount | 71668.92 |
| Total Medical Medicare Payment Amount | 55953.96 |
| Total Medical Medicare Standardized Payment Amount | 52210.73 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 78 |
| Number Of Beneficiaries Age 65 to 74 | 89 |
| Number Of Beneficiaries Age 75 to 84 | 61 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 105 |
| Number Of Male Beneficiaries | 144 |
| Number Of Non Hispanic White Beneficiaries | 153 |
| Number Of Black or African American Beneficiaries | 48 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 156 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 93 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 68 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 3.3375 |