| National Provider Identifier [NPI]: | 1568524098 |
| Last Name Of The Provider | EDWARDS |
| First Name Of The Provider | ELENA |
| 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 | 6420 N CALIFORNIA AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606455253 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 8015 |
| Number Of Medicare Beneficiaries | 509 |
| Total Submitted Charge Amount | 1101029 |
| Total Medicare Allowed Amount | 519866.81 |
| Total Medicare Payment Amount | 386022.5 |
| Total Medicare Standardized Payment Amount | 363814.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 657 |
| Number Of Medicare Beneficiaries With Drug Services | 106 |
| Total Drug Submitted ChargeAmount | 8188 |
| Total Drug Medicare AllowedAmount | 1390.47 |
| Total Drug Medicare PaymentAmount | 1133.52 |
| Total Drug Medicare Standardized Payment Amount | 1133.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 7358 |
| Number Of Medicare Beneficiaries With Medical Services | 509 |
| Total Medical Submitted Charge Amount | 1092841 |
| Total Medical Medicare Allowed Amount | 518476.34 |
| Total Medical Medicare Payment Amount | 384888.98 |
| Total Medical Medicare Standardized Payment Amount | 362681.03 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 78 |
| Number Of Beneficiaries Age 65 to 74 | 180 |
| Number Of Beneficiaries Age 75 to 84 | 141 |
| Number Of Beneficiaries Age Greater 84 | 110 |
| Number Of Female Beneficiaries | 364 |
| Number Of Male Beneficiaries | 145 |
| Number Of Non Hispanic White Beneficiaries | 450 |
| 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 | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 151 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 358 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3331 |