| National Provider Identifier [NPI]: | 1669440079 |
| Last Name Of The Provider | ILJAS |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 15146 LEVAN RD |
| Street Address 2 Of The Provider | SUITE 46 |
| City Of The Provider | LIVONIA |
| Zip Code Of The Provider | 481545027 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 161 |
| Number Of Services | 6412 |
| Number Of Medicare Beneficiaries | 1846 |
| Total Submitted Charge Amount | 3579395.56 |
| Total Medicare Allowed Amount | 1583894.17 |
| Total Medicare Payment Amount | 1233197.76 |
| Total Medicare Standardized Payment Amount | 1190793.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2335 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 5606.24 |
| Total Drug Medicare AllowedAmount | 476.55 |
| Total Drug Medicare PaymentAmount | 373.55 |
| Total Drug Medicare Standardized Payment Amount | 373.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 158 |
| Number Of Medical Services | 4077 |
| Number Of Medicare Beneficiaries With Medical Services | 1846 |
| Total Medical Submitted Charge Amount | 3573789.32 |
| Total Medical Medicare Allowed Amount | 1583417.62 |
| Total Medical Medicare Payment Amount | 1232824.21 |
| Total Medical Medicare Standardized Payment Amount | 1190420.23 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 310 |
| Number Of Beneficiaries Age 65 to 74 | 525 |
| Number Of Beneficiaries Age 75 to 84 | 591 |
| Number Of Beneficiaries Age Greater 84 | 420 |
| Number Of Female Beneficiaries | 1053 |
| Number Of Male Beneficiaries | 793 |
| Number Of Non Hispanic White Beneficiaries | 1258 |
| Number Of Black or African American Beneficiaries | 533 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1410 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 436 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 55 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 2.9958 |