| National Provider Identifier [NPI]: | 1386832855 |
| Last Name Of The Provider | KEFALAS |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1770 E LAKE SHORE DR |
| Street Address 2 Of The Provider | SUITE LL1 |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 625213832 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 118 |
| Number Of Services | 5452 |
| Number Of Medicare Beneficiaries | 946 |
| Total Submitted Charge Amount | 2392805.19 |
| Total Medicare Allowed Amount | 463570.53 |
| Total Medicare Payment Amount | 342265.14 |
| Total Medicare Standardized Payment Amount | 355620.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1728 |
| Number Of Medicare Beneficiaries With Drug Services | 326 |
| Total Drug Submitted ChargeAmount | 49318.48 |
| Total Drug Medicare AllowedAmount | 8634.66 |
| Total Drug Medicare PaymentAmount | 6334.85 |
| Total Drug Medicare Standardized Payment Amount | 6334.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 115 |
| Number Of Medical Services | 3724 |
| Number Of Medicare Beneficiaries With Medical Services | 946 |
| Total Medical Submitted Charge Amount | 2343486.71 |
| Total Medical Medicare Allowed Amount | 454935.87 |
| Total Medical Medicare Payment Amount | 335930.29 |
| Total Medical Medicare Standardized Payment Amount | 349285.66 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 119 |
| Number Of Beneficiaries Age 65 to 74 | 386 |
| Number Of Beneficiaries Age 75 to 84 | 293 |
| Number Of Beneficiaries Age Greater 84 | 148 |
| Number Of Female Beneficiaries | 582 |
| Number Of Male Beneficiaries | 364 |
| Number Of Non Hispanic White Beneficiaries | 876 |
| Number Of Black or African American Beneficiaries | 56 |
| 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 | 794 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 152 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1761 |