| National Provider Identifier [NPI]: | 1932163623 |
| Last Name Of The Provider | STELLA |
| First Name Of The Provider | DOMINICK |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2338 NEW ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLUE ISLAND |
| Zip Code Of The Provider | 604062402 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 21647 |
| Number Of Medicare Beneficiaries | 2459 |
| Total Submitted Charge Amount | 1630267.25 |
| Total Medicare Allowed Amount | 527903.91 |
| Total Medicare Payment Amount | 398357.91 |
| Total Medicare Standardized Payment Amount | 375297.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 15235 |
| Number Of Medicare Beneficiaries With Drug Services | 166 |
| Total Drug Submitted ChargeAmount | 20081.25 |
| Total Drug Medicare AllowedAmount | 4696.13 |
| Total Drug Medicare PaymentAmount | 3672.14 |
| Total Drug Medicare Standardized Payment Amount | 3672.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 108 |
| Number Of Medical Services | 6412 |
| Number Of Medicare Beneficiaries With Medical Services | 2459 |
| Total Medical Submitted Charge Amount | 1610186 |
| Total Medical Medicare Allowed Amount | 523207.78 |
| Total Medical Medicare Payment Amount | 394685.77 |
| Total Medical Medicare Standardized Payment Amount | 371625.34 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 145 |
| Number Of Beneficiaries Age 65 to 74 | 867 |
| Number Of Beneficiaries Age 75 to 84 | 914 |
| Number Of Beneficiaries Age Greater 84 | 533 |
| Number Of Female Beneficiaries | 1274 |
| Number Of Male Beneficiaries | 1185 |
| Number Of Non Hispanic White Beneficiaries | 2239 |
| Number Of Black or African American Beneficiaries | 104 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 73 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2219 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 240 |
| Percent Of With Atrial Fibrillation | 37 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.695 |