| National Provider Identifier [NPI]: | 1952406415 |
| Last Name Of The Provider | NASRALLA |
| First Name Of The Provider | CRAIG |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 RANDALL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GENEVA |
| Zip Code Of The Provider | 601344200 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 160 |
| Number Of Services | 5065 |
| Number Of Medicare Beneficiaries | 2757 |
| Total Submitted Charge Amount | 496652 |
| Total Medicare Allowed Amount | 151275.7 |
| Total Medicare Payment Amount | 118443.58 |
| Total Medicare Standardized Payment Amount | 113357.28 |
| 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 | 160 |
| Number Of Medical Services | 5065 |
| Number Of Medicare Beneficiaries With Medical Services | 2757 |
| Total Medical Submitted Charge Amount | 496652 |
| Total Medical Medicare Allowed Amount | 151275.7 |
| Total Medical Medicare Payment Amount | 118443.58 |
| Total Medical Medicare Standardized Payment Amount | 113357.28 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 217 |
| Number Of Beneficiaries Age 65 to 74 | 1261 |
| Number Of Beneficiaries Age 75 to 84 | 847 |
| Number Of Beneficiaries Age Greater 84 | 432 |
| Number Of Female Beneficiaries | 1892 |
| Number Of Male Beneficiaries | 865 |
| Number Of Non Hispanic White Beneficiaries | 2580 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | 80 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2480 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 277 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2633 |