| National Provider Identifier [NPI]: | 1942361662 |
| Last Name Of The Provider | BAMROLIA |
| First Name Of The Provider | ANSHUL |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 202 S GREENLEAF ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | GURNEE |
| Zip Code Of The Provider | 600313399 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 75016 |
| Number Of Medicare Beneficiaries | 583 |
| Total Submitted Charge Amount | 3686123.99 |
| Total Medicare Allowed Amount | 1791072.41 |
| Total Medicare Payment Amount | 1403426.05 |
| Total Medicare Standardized Payment Amount | 1372512.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 55 |
| Number Of Drug Services | 65401 |
| Number Of Medicare Beneficiaries With Drug Services | 142 |
| Total Drug Submitted ChargeAmount | 2745090.69 |
| Total Drug Medicare AllowedAmount | 1326409.51 |
| Total Drug Medicare PaymentAmount | 1039936.89 |
| Total Drug Medicare Standardized Payment Amount | 1039936.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 9615 |
| Number Of Medicare Beneficiaries With Medical Services | 583 |
| Total Medical Submitted Charge Amount | 941033.3 |
| Total Medical Medicare Allowed Amount | 464662.9 |
| Total Medical Medicare Payment Amount | 363489.16 |
| Total Medical Medicare Standardized Payment Amount | 332575.35 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 121 |
| Number Of Beneficiaries Age 65 to 74 | 215 |
| Number Of Beneficiaries Age 75 to 84 | 172 |
| Number Of Beneficiaries Age Greater 84 | 75 |
| Number Of Female Beneficiaries | 337 |
| Number Of Male Beneficiaries | 246 |
| Number Of Non Hispanic White Beneficiaries | 364 |
| Number Of Black or African American Beneficiaries | 126 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 67 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 391 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 192 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 39 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.3167 |