| National Provider Identifier [NPI]: | 1740276823 |
| Last Name Of The Provider | STANISIC |
| First Name Of The Provider | SLOBODAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2727 MADISON RD |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | CINCINNATI |
| Zip Code Of The Provider | 452092276 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 94 |
| Number Of Services | 80665 |
| Number Of Medicare Beneficiaries | 396 |
| Total Submitted Charge Amount | 6267324.9 |
| Total Medicare Allowed Amount | 2015610.36 |
| Total Medicare Payment Amount | 1574918.34 |
| Total Medicare Standardized Payment Amount | 1582079.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 53 |
| Number Of Drug Services | 73662 |
| Number Of Medicare Beneficiaries With Drug Services | 94 |
| Total Drug Submitted ChargeAmount | 4704001.63 |
| Total Drug Medicare AllowedAmount | 1588646.4 |
| Total Drug Medicare PaymentAmount | 1244905.44 |
| Total Drug Medicare Standardized Payment Amount | 1244905.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 7003 |
| Number Of Medicare Beneficiaries With Medical Services | 396 |
| Total Medical Submitted Charge Amount | 1563323.27 |
| Total Medical Medicare Allowed Amount | 426963.96 |
| Total Medical Medicare Payment Amount | 330012.9 |
| Total Medical Medicare Standardized Payment Amount | 337174.52 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 166 |
| Number Of Beneficiaries Age 75 to 84 | 127 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 219 |
| Number Of Male Beneficiaries | 177 |
| Number Of Non Hispanic White Beneficiaries | 345 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 337 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 46 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 2.3137 |