| National Provider Identifier [NPI]: | 1942302864 |
| Last Name Of The Provider | BANGASH |
| First Name Of The Provider | SULEMAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1750 N RANDALL RD |
| Street Address 2 Of The Provider | SUITE 120 |
| City Of The Provider | ELGIN |
| Zip Code Of The Provider | 601237900 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 12761 |
| Number Of Medicare Beneficiaries | 2100 |
| Total Submitted Charge Amount | 4201825.13 |
| Total Medicare Allowed Amount | 1778152.52 |
| Total Medicare Payment Amount | 1356220.21 |
| Total Medicare Standardized Payment Amount | 1178114.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 234 |
| Number Of Medicare Beneficiaries With Drug Services | 70 |
| Total Drug Submitted ChargeAmount | 20952.01 |
| Total Drug Medicare AllowedAmount | 13400.56 |
| Total Drug Medicare PaymentAmount | 10339.64 |
| Total Drug Medicare Standardized Payment Amount | 10339.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 12527 |
| Number Of Medicare Beneficiaries With Medical Services | 2100 |
| Total Medical Submitted Charge Amount | 4180873.12 |
| Total Medical Medicare Allowed Amount | 1764751.96 |
| Total Medical Medicare Payment Amount | 1345880.57 |
| Total Medical Medicare Standardized Payment Amount | 1167774.95 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 864 |
| Number Of Beneficiaries Age 75 to 84 | 859 |
| Number Of Beneficiaries Age Greater 84 | 321 |
| Number Of Female Beneficiaries | 1008 |
| Number Of Male Beneficiaries | 1092 |
| Number Of Non Hispanic White Beneficiaries | 2033 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2025 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0544 |