| National Provider Identifier [NPI]: | 1316955149 |
| Last Name Of The Provider | PURI |
| First Name Of The Provider | RAJEEV |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 SOUTH KENNEDY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRADLEY |
| Zip Code Of The Provider | 60915 |
| 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 | 136 |
| Number Of Services | 5479 |
| Number Of Medicare Beneficiaries | 732 |
| Total Submitted Charge Amount | 2457048 |
| Total Medicare Allowed Amount | 416168.89 |
| Total Medicare Payment Amount | 312491.34 |
| Total Medicare Standardized Payment Amount | 322242.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1981 |
| Number Of Medicare Beneficiaries With Drug Services | 197 |
| Total Drug Submitted ChargeAmount | 109588 |
| Total Drug Medicare AllowedAmount | 36678.85 |
| Total Drug Medicare PaymentAmount | 27516.36 |
| Total Drug Medicare Standardized Payment Amount | 27516.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 130 |
| Number Of Medical Services | 3498 |
| Number Of Medicare Beneficiaries With Medical Services | 732 |
| Total Medical Submitted Charge Amount | 2347460 |
| Total Medical Medicare Allowed Amount | 379490.04 |
| Total Medical Medicare Payment Amount | 284974.98 |
| Total Medical Medicare Standardized Payment Amount | 294726.27 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 113 |
| Number Of Beneficiaries Age 65 to 74 | 309 |
| Number Of Beneficiaries Age 75 to 84 | 226 |
| Number Of Beneficiaries Age Greater 84 | 84 |
| Number Of Female Beneficiaries | 465 |
| Number Of Male Beneficiaries | 267 |
| Number Of Non Hispanic White Beneficiaries | 668 |
| Number Of Black or African American Beneficiaries | 43 |
| 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 | 624 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 108 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2142 |