| National Provider Identifier [NPI]: | 1699775916 |
| Last Name Of The Provider | PROSPERO |
| First Name Of The Provider | BELLA |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 17901 GOVERNORS HWY |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | HOMEWOOD |
| Zip Code Of The Provider | 604301144 |
| 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 | 37 |
| Number Of Services | 1479 |
| Number Of Medicare Beneficiaries | 308 |
| Total Submitted Charge Amount | 192831 |
| Total Medicare Allowed Amount | 103580.37 |
| Total Medicare Payment Amount | 69755.39 |
| Total Medicare Standardized Payment Amount | 65929.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 69 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 2260 |
| Total Drug Medicare AllowedAmount | 1367.2 |
| Total Drug Medicare PaymentAmount | 1328.12 |
| Total Drug Medicare Standardized Payment Amount | 1328.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 1410 |
| Number Of Medicare Beneficiaries With Medical Services | 308 |
| Total Medical Submitted Charge Amount | 190571 |
| Total Medical Medicare Allowed Amount | 102213.17 |
| Total Medical Medicare Payment Amount | 68427.27 |
| Total Medical Medicare Standardized Payment Amount | 64601.82 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 124 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 215 |
| Number Of Male Beneficiaries | 93 |
| Number Of Non Hispanic White Beneficiaries | 115 |
| Number Of Black or African American Beneficiaries | 177 |
| 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 | 260 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.2077 |