| National Provider Identifier [NPI]: | 1316950033 |
| Last Name Of The Provider | ESTRADA |
| First Name Of The Provider | DOLORES |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 210 W. MCKINLEY AVE |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 62526 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 196 |
| Number Of Services | 158478 |
| Number Of Medicare Beneficiaries | 483 |
| Total Submitted Charge Amount | 6511612 |
| Total Medicare Allowed Amount | 1884532.4 |
| Total Medicare Payment Amount | 1472469.4 |
| Total Medicare Standardized Payment Amount | 1488487.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 70 |
| Number Of Drug Services | 141769 |
| Number Of Medicare Beneficiaries With Drug Services | 173 |
| Total Drug Submitted ChargeAmount | 4330570 |
| Total Drug Medicare AllowedAmount | 1227701.49 |
| Total Drug Medicare PaymentAmount | 954652.31 |
| Total Drug Medicare Standardized Payment Amount | 954652.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 126 |
| Number Of Medical Services | 16709 |
| Number Of Medicare Beneficiaries With Medical Services | 483 |
| Total Medical Submitted Charge Amount | 2181042 |
| Total Medical Medicare Allowed Amount | 656830.91 |
| Total Medical Medicare Payment Amount | 517817.09 |
| Total Medical Medicare Standardized Payment Amount | 533835.51 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 83 |
| Number Of Beneficiaries Age 65 to 74 | 167 |
| Number Of Beneficiaries Age 75 to 84 | 154 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 273 |
| Number Of Male Beneficiaries | 210 |
| Number Of Non Hispanic White Beneficiaries | 422 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 368 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 115 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 50 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 2.1217 |