| National Provider Identifier [NPI]: | 1255434353 |
| Last Name Of The Provider | THAKUR |
| First Name Of The Provider | ANITA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2323 N LAKE DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MILWAUKEE |
| Zip Code Of The Provider | 53211 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 1960 |
| Number Of Medicare Beneficiaries | 879 |
| Total Submitted Charge Amount | 544421 |
| Total Medicare Allowed Amount | 67353.35 |
| Total Medicare Payment Amount | 51797.65 |
| Total Medicare Standardized Payment Amount | 43245.66 |
| 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 | 1960 |
| Number Of Medicare Beneficiaries With Medical Services | 879 |
| Total Medical Submitted Charge Amount | 544421 |
| Total Medical Medicare Allowed Amount | 67353.35 |
| Total Medical Medicare Payment Amount | 51797.65 |
| Total Medical Medicare Standardized Payment Amount | 43245.66 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 396 |
| Number Of Beneficiaries Age 75 to 84 | 278 |
| Number Of Beneficiaries Age Greater 84 | 106 |
| Number Of Female Beneficiaries | 509 |
| Number Of Male Beneficiaries | 370 |
| Number Of Non Hispanic White Beneficiaries | 704 |
| Number Of Black or African American Beneficiaries | 125 |
| 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 | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 739 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 140 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2257 |