| National Provider Identifier [NPI]: | 1861459364 |
| Last Name Of The Provider | RAMIREZ |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 919 MAIN ST |
| Street Address 2 Of The Provider | STE 102 |
| City Of The Provider | DYER |
| Zip Code Of The Provider | 463113717 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pediatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 1486 |
| Number Of Medicare Beneficiaries | 396 |
| Total Submitted Charge Amount | 212379.09 |
| Total Medicare Allowed Amount | 122150.72 |
| Total Medicare Payment Amount | 91006.43 |
| Total Medicare Standardized Payment Amount | 96717.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 124 |
| Number Of Medicare Beneficiaries With Drug Services | 95 |
| Total Drug Submitted ChargeAmount | 5074.09 |
| Total Drug Medicare AllowedAmount | 3719.07 |
| Total Drug Medicare PaymentAmount | 3631.47 |
| Total Drug Medicare Standardized Payment Amount | 3631.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 1362 |
| Number Of Medicare Beneficiaries With Medical Services | 396 |
| Total Medical Submitted Charge Amount | 207305 |
| Total Medical Medicare Allowed Amount | 118431.65 |
| Total Medical Medicare Payment Amount | 87374.96 |
| Total Medical Medicare Standardized Payment Amount | 93086 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 167 |
| Number Of Beneficiaries Age 75 to 84 | 126 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 305 |
| Number Of Male Beneficiaries | 91 |
| Number Of Non Hispanic White Beneficiaries | 268 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 88 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 344 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3096 |