| National Provider Identifier [NPI]: | 1558369231 |
| Last Name Of The Provider | PILLSBURY |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 901 BIESTERFIELD RD |
| Street Address 2 Of The Provider | SUITE 310 |
| City Of The Provider | ELK GROVE VILLAGE |
| Zip Code Of The Provider | 600073392 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 14205 |
| Number Of Medicare Beneficiaries | 747 |
| Total Submitted Charge Amount | 639068 |
| Total Medicare Allowed Amount | 346258.2 |
| Total Medicare Payment Amount | 267120.91 |
| Total Medicare Standardized Payment Amount | 253146.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 11490 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 66206 |
| Total Drug Medicare AllowedAmount | 38138.84 |
| Total Drug Medicare PaymentAmount | 29785.69 |
| Total Drug Medicare Standardized Payment Amount | 29785.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 2715 |
| Number Of Medicare Beneficiaries With Medical Services | 747 |
| Total Medical Submitted Charge Amount | 572862 |
| Total Medical Medicare Allowed Amount | 308119.36 |
| Total Medical Medicare Payment Amount | 237335.22 |
| Total Medical Medicare Standardized Payment Amount | 223360.36 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 115 |
| Number Of Beneficiaries Age 65 to 74 | 237 |
| Number Of Beneficiaries Age 75 to 84 | 245 |
| Number Of Beneficiaries Age Greater 84 | 150 |
| Number Of Female Beneficiaries | 366 |
| Number Of Male Beneficiaries | 381 |
| Number Of Non Hispanic White Beneficiaries | 625 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 39 |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 581 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 166 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 58 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 3.8249 |