| National Provider Identifier [NPI]: | 1013173962 |
| Last Name Of The Provider | GHAI |
| First Name Of The Provider | RITU |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1653 W CONGRESS PKWY |
| Street Address 2 Of The Provider | JELKE -541 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606123833 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 5337 |
| Number Of Medicare Beneficiaries | 910 |
| Total Submitted Charge Amount | 931214 |
| Total Medicare Allowed Amount | 238646.5 |
| Total Medicare Payment Amount | 186472.74 |
| Total Medicare Standardized Payment Amount | 135445.26 |
| 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 | 26 |
| Number Of Medical Services | 5337 |
| Number Of Medicare Beneficiaries With Medical Services | 910 |
| Total Medical Submitted Charge Amount | 931214 |
| Total Medical Medicare Allowed Amount | 238646.5 |
| Total Medical Medicare Payment Amount | 186472.74 |
| Total Medical Medicare Standardized Payment Amount | 135445.26 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 222 |
| Number Of Beneficiaries Age 65 to 74 | 407 |
| Number Of Beneficiaries Age 75 to 84 | 223 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 564 |
| Number Of Male Beneficiaries | 346 |
| Number Of Non Hispanic White Beneficiaries | 515 |
| Number Of Black or African American Beneficiaries | 289 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 80 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 625 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 285 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 39 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.9652 |