| National Provider Identifier [NPI]: | 1770519936 |
| Last Name Of The Provider | GIRGIS |
| First Name Of The Provider | SAMUEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 908 N ELM ST |
| Street Address 2 Of The Provider | SUITE 306 |
| City Of The Provider | HINSDALE |
| Zip Code Of The Provider | 605213635 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Otolaryngology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 4421 |
| Number Of Medicare Beneficiaries | 890 |
| Total Submitted Charge Amount | 979261 |
| Total Medicare Allowed Amount | 275437.59 |
| Total Medicare Payment Amount | 203755.15 |
| Total Medicare Standardized Payment Amount | 187534.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1704 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 2556 |
| Total Drug Medicare AllowedAmount | 320.39 |
| Total Drug Medicare PaymentAmount | 251.18 |
| Total Drug Medicare Standardized Payment Amount | 251.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 2717 |
| Number Of Medicare Beneficiaries With Medical Services | 890 |
| Total Medical Submitted Charge Amount | 976705 |
| Total Medical Medicare Allowed Amount | 275117.2 |
| Total Medical Medicare Payment Amount | 203503.97 |
| Total Medical Medicare Standardized Payment Amount | 187282.91 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 377 |
| Number Of Beneficiaries Age 75 to 84 | 286 |
| Number Of Beneficiaries Age Greater 84 | 166 |
| Number Of Female Beneficiaries | 527 |
| Number Of Male Beneficiaries | 363 |
| Number Of Non Hispanic White Beneficiaries | 819 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 834 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0022 |