| National Provider Identifier [NPI]: | 1679628374 |
| Last Name Of The Provider | SANFILIPPO |
| First Name Of The Provider | MICHELLE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MPAS, PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 BIESTERFIELD RD. EBERLE BLDG, SUITE 610 |
| Street Address 2 Of The Provider | ALEXIAN BROTHERS NEUROSCIENCES INSTITUTE |
| City Of The Provider | ELK GROVE VILLAGE |
| Zip Code Of The Provider | 60007 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 313 |
| Number Of Medicare Beneficiaries | 262 |
| Total Submitted Charge Amount | 60430 |
| Total Medicare Allowed Amount | 35084.84 |
| Total Medicare Payment Amount | 26049.87 |
| Total Medicare Standardized Payment Amount | 28957.44 |
| 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 | 8 |
| Number Of Medical Services | 313 |
| Number Of Medicare Beneficiaries With Medical Services | 262 |
| Total Medical Submitted Charge Amount | 60430 |
| Total Medical Medicare Allowed Amount | 35084.84 |
| Total Medical Medicare Payment Amount | 26049.87 |
| Total Medical Medicare Standardized Payment Amount | 28957.44 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 69 |
| Number Of Beneficiaries Age 75 to 84 | 116 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 159 |
| Number Of Male Beneficiaries | 103 |
| Number Of Non Hispanic White Beneficiaries | 237 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 220 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 26 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1437 |