| National Provider Identifier [NPI]: | 1215938097 |
| Last Name Of The Provider | NG |
| First Name Of The Provider | FREDERICK |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | ST. ALEXIUS MEDICAL CENTER / PATHOLOGY DEPARTMENT |
| Street Address 2 Of The Provider | 1555 NORTH BARRINGTON ROAD |
| City Of The Provider | HOFFMAN ESTATES |
| Zip Code Of The Provider | 60194 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 3325 |
| Number Of Medicare Beneficiaries | 1309 |
| Total Submitted Charge Amount | 1028395.9 |
| Total Medicare Allowed Amount | 123516.25 |
| Total Medicare Payment Amount | 95806.85 |
| Total Medicare Standardized Payment Amount | 70273.15 |
| 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 | 30 |
| Number Of Medical Services | 3325 |
| Number Of Medicare Beneficiaries With Medical Services | 1309 |
| Total Medical Submitted Charge Amount | 1028395.9 |
| Total Medical Medicare Allowed Amount | 123516.25 |
| Total Medical Medicare Payment Amount | 95806.85 |
| Total Medical Medicare Standardized Payment Amount | 70273.15 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 145 |
| Number Of Beneficiaries Age 65 to 74 | 612 |
| Number Of Beneficiaries Age 75 to 84 | 404 |
| Number Of Beneficiaries Age Greater 84 | 148 |
| Number Of Female Beneficiaries | 694 |
| Number Of Male Beneficiaries | 615 |
| Number Of Non Hispanic White Beneficiaries | 1109 |
| Number Of Black or African American Beneficiaries | 29 |
| Number Of AsianPacific Islander Beneficiaries | 64 |
| Number Of Hispanic Beneficiaries | 80 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1115 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 194 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5127 |