| National Provider Identifier [NPI]: | 1922053511 |
| Last Name Of The Provider | STATHOPOULOS |
| First Name Of The Provider | TOM |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1555 BARRINGTON RD |
| Street Address 2 Of The Provider | SUITE 2300B |
| City Of The Provider | HOFFMAN ESTATES |
| Zip Code Of The Provider | 601691019 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 4678 |
| Number Of Medicare Beneficiaries | 835 |
| Total Submitted Charge Amount | 1222090 |
| Total Medicare Allowed Amount | 461718.48 |
| Total Medicare Payment Amount | 352984.99 |
| Total Medicare Standardized Payment Amount | 339829.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 430 |
| Number Of Medicare Beneficiaries With Drug Services | 110 |
| Total Drug Submitted ChargeAmount | 37628 |
| Total Drug Medicare AllowedAmount | 22618.37 |
| Total Drug Medicare PaymentAmount | 17533.04 |
| Total Drug Medicare Standardized Payment Amount | 17533.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 4248 |
| Number Of Medicare Beneficiaries With Medical Services | 835 |
| Total Medical Submitted Charge Amount | 1184462 |
| Total Medical Medicare Allowed Amount | 439100.11 |
| Total Medical Medicare Payment Amount | 335451.95 |
| Total Medical Medicare Standardized Payment Amount | 322296.17 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 277 |
| Number Of Beneficiaries Age 75 to 84 | 254 |
| Number Of Beneficiaries Age Greater 84 | 246 |
| Number Of Female Beneficiaries | 482 |
| Number Of Male Beneficiaries | 353 |
| Number Of Non Hispanic White Beneficiaries | 698 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | 55 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 615 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 220 |
| Percent Of With Atrial Fibrillation | 40 |
| Percent Of With Alzheimers Disease or Dementia | 37 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 55 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.6279 |