| National Provider Identifier [NPI]: | 1215966684 |
| Last Name Of The Provider | STAVRAKOS |
| First Name Of The Provider | JOHN |
| 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 | 720 OSTERMAN AVE |
| Street Address 2 Of The Provider | SUITE 103 |
| City Of The Provider | DEERFIELD |
| Zip Code Of The Provider | 600154471 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 3439 |
| Number Of Medicare Beneficiaries | 633 |
| Total Submitted Charge Amount | 231127.74 |
| Total Medicare Allowed Amount | 144128.72 |
| Total Medicare Payment Amount | 104258.68 |
| Total Medicare Standardized Payment Amount | 103628.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 403 |
| Number Of Medicare Beneficiaries With Drug Services | 270 |
| Total Drug Submitted ChargeAmount | 19637 |
| Total Drug Medicare AllowedAmount | 7773.49 |
| Total Drug Medicare PaymentAmount | 7525.89 |
| Total Drug Medicare Standardized Payment Amount | 7525.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 3036 |
| Number Of Medicare Beneficiaries With Medical Services | 633 |
| Total Medical Submitted Charge Amount | 211490.74 |
| Total Medical Medicare Allowed Amount | 136355.23 |
| Total Medical Medicare Payment Amount | 96732.79 |
| Total Medical Medicare Standardized Payment Amount | 96102.51 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 292 |
| Number Of Beneficiaries Age 75 to 84 | 207 |
| Number Of Beneficiaries Age Greater 84 | 116 |
| Number Of Female Beneficiaries | 297 |
| Number Of Male Beneficiaries | 336 |
| Number Of Non Hispanic White Beneficiaries | 601 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 621 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 6 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8578 |