| National Provider Identifier [NPI]: | 1093758435 |
| Last Name Of The Provider | KEANE |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 16105 S LA GRANGE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORLAND PARK |
| Zip Code Of The Provider | 604675503 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 7020 |
| Number Of Medicare Beneficiaries | 1514 |
| Total Submitted Charge Amount | 742020 |
| Total Medicare Allowed Amount | 407723.23 |
| Total Medicare Payment Amount | 290531.98 |
| Total Medicare Standardized Payment Amount | 264242.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 7020 |
| Number Of Medicare Beneficiaries With Medical Services | 1514 |
| Total Medical Submitted Charge Amount | 742020 |
| Total Medical Medicare Allowed Amount | 407723.23 |
| Total Medical Medicare Payment Amount | 290531.98 |
| Total Medical Medicare Standardized Payment Amount | 264242.08 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 604 |
| Number Of Beneficiaries Age 75 to 84 | 611 |
| Number Of Beneficiaries Age Greater 84 | 256 |
| Number Of Female Beneficiaries | 799 |
| Number Of Male Beneficiaries | 715 |
| Number Of Non Hispanic White Beneficiaries | 1442 |
| Number Of Black or African American Beneficiaries | 31 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1466 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.065 |