| National Provider Identifier [NPI]: | 1659358703 |
| Last Name Of The Provider | SY |
| First Name Of The Provider | ESTHER |
| 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 | 11475 N 2ND ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MACHESNEY PARK |
| Zip Code Of The Provider | 611151285 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 386 |
| Number Of Medicare Beneficiaries | 234 |
| Total Submitted Charge Amount | 40319 |
| Total Medicare Allowed Amount | 20944.69 |
| Total Medicare Payment Amount | 13814.65 |
| Total Medicare Standardized Payment Amount | 14552.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 30 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 940 |
| Total Drug Medicare AllowedAmount | 243.68 |
| Total Drug Medicare PaymentAmount | 195.14 |
| Total Drug Medicare Standardized Payment Amount | 195.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 356 |
| Number Of Medicare Beneficiaries With Medical Services | 234 |
| Total Medical Submitted Charge Amount | 39379 |
| Total Medical Medicare Allowed Amount | 20701.01 |
| Total Medical Medicare Payment Amount | 13619.51 |
| Total Medical Medicare Standardized Payment Amount | 14357.27 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 120 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 141 |
| Number Of Male Beneficiaries | 93 |
| Number Of Non Hispanic White Beneficiaries | 205 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 188 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0003 |