| National Provider Identifier [NPI]: | 1346235934 |
| Last Name Of The Provider | CARANDANG |
| First Name Of The Provider | GODOFREDO |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7804 W COLLEGE DR |
| Street Address 2 Of The Provider | SUITE 1NW |
| City Of The Provider | PALOS HEIGHTS |
| Zip Code Of The Provider | 604631025 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 2957 |
| Number Of Medicare Beneficiaries | 896 |
| Total Submitted Charge Amount | 568961.52 |
| Total Medicare Allowed Amount | 289829.39 |
| Total Medicare Payment Amount | 226000.64 |
| Total Medicare Standardized Payment Amount | 210943.3 |
| 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 | 11 |
| Number Of Medical Services | 2957 |
| Number Of Medicare Beneficiaries With Medical Services | 896 |
| Total Medical Submitted Charge Amount | 568961.52 |
| Total Medical Medicare Allowed Amount | 289829.39 |
| Total Medical Medicare Payment Amount | 226000.64 |
| Total Medical Medicare Standardized Payment Amount | 210943.3 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 141 |
| Number Of Beneficiaries Age 65 to 74 | 247 |
| Number Of Beneficiaries Age 75 to 84 | 286 |
| Number Of Beneficiaries Age Greater 84 | 222 |
| Number Of Female Beneficiaries | 514 |
| Number Of Male Beneficiaries | 382 |
| Number Of Non Hispanic White Beneficiaries | 394 |
| Number Of Black or African American Beneficiaries | 467 |
| 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 | 542 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 354 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 43 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 63 |
| Percent Of With Chronic Kidney Disease | 68 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 61 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 3.1495 |