| National Provider Identifier [NPI]: | 1730127978 |
| Last Name Of The Provider | KOZIOL |
| First Name Of The Provider | LADONNA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1700 W CENTRAL RD |
| Street Address 2 Of The Provider | SUITE 260 |
| City Of The Provider | ARLINGTON HEIGHTS |
| Zip Code Of The Provider | 600052474 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 79544 |
| Number Of Medicare Beneficiaries | 612 |
| Total Submitted Charge Amount | 3239489.54 |
| Total Medicare Allowed Amount | 2114139.37 |
| Total Medicare Payment Amount | 1640684.57 |
| Total Medicare Standardized Payment Amount | 1612085.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 76401 |
| Number Of Medicare Beneficiaries With Drug Services | 355 |
| Total Drug Submitted ChargeAmount | 2667052.54 |
| Total Drug Medicare AllowedAmount | 1792701.4 |
| Total Drug Medicare PaymentAmount | 1403189.02 |
| Total Drug Medicare Standardized Payment Amount | 1403189.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 3143 |
| Number Of Medicare Beneficiaries With Medical Services | 612 |
| Total Medical Submitted Charge Amount | 572437 |
| Total Medical Medicare Allowed Amount | 321437.97 |
| Total Medical Medicare Payment Amount | 237495.55 |
| Total Medical Medicare Standardized Payment Amount | 208896.03 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 230 |
| Number Of Beneficiaries Age 75 to 84 | 255 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 480 |
| Number Of Male Beneficiaries | 132 |
| Number Of Non Hispanic White Beneficiaries | 585 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 591 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 32 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1711 |