| National Provider Identifier [NPI]: | 1023347135 |
| Last Name Of The Provider | ZOFAKIS |
| First Name Of The Provider | TINA |
| 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 | 5783 N LINCOLN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606594722 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 877 |
| Number Of Medicare Beneficiaries | 217 |
| Total Submitted Charge Amount | 82256.91 |
| Total Medicare Allowed Amount | 70920.54 |
| Total Medicare Payment Amount | 50193.1 |
| Total Medicare Standardized Payment Amount | 47460.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 47 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 1950 |
| Total Drug Medicare AllowedAmount | 711.17 |
| Total Drug Medicare PaymentAmount | 689.07 |
| Total Drug Medicare Standardized Payment Amount | 689.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 830 |
| Number Of Medicare Beneficiaries With Medical Services | 217 |
| Total Medical Submitted Charge Amount | 80306.91 |
| Total Medical Medicare Allowed Amount | 70209.37 |
| Total Medical Medicare Payment Amount | 49504.03 |
| Total Medical Medicare Standardized Payment Amount | 46771.29 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 69 |
| Number Of Beneficiaries Age 75 to 84 | 86 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 127 |
| Number Of Male Beneficiaries | 90 |
| Number Of Non Hispanic White Beneficiaries | 189 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 155 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 62 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0814 |