| National Provider Identifier [NPI]: | 1467531293 |
| Last Name Of The Provider | STAICU |
| First Name Of The Provider | IRINA |
| 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 | 912 W NORTHEAST HWY |
| Street Address 2 Of The Provider | #100 |
| City Of The Provider | FOX RIVER GROVE |
| Zip Code Of The Provider | 60021 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 2855 |
| Number Of Medicare Beneficiaries | 754 |
| Total Submitted Charge Amount | 1156961 |
| Total Medicare Allowed Amount | 430927.25 |
| Total Medicare Payment Amount | 329313.52 |
| Total Medicare Standardized Payment Amount | 340042.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 229 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 25178 |
| Total Drug Medicare AllowedAmount | 11026.53 |
| Total Drug Medicare PaymentAmount | 8644.7 |
| Total Drug Medicare Standardized Payment Amount | 8644.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 2626 |
| Number Of Medicare Beneficiaries With Medical Services | 754 |
| Total Medical Submitted Charge Amount | 1131783 |
| Total Medical Medicare Allowed Amount | 419900.72 |
| Total Medical Medicare Payment Amount | 320668.82 |
| Total Medical Medicare Standardized Payment Amount | 331397.54 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 289 |
| Number Of Beneficiaries Age 75 to 84 | 269 |
| Number Of Beneficiaries Age Greater 84 | 152 |
| Number Of Female Beneficiaries | 432 |
| Number Of Male Beneficiaries | 322 |
| Number Of Non Hispanic White Beneficiaries | 708 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 698 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 35 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 58 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6036 |