| National Provider Identifier [NPI]: | 1942297627 |
| Last Name Of The Provider | TAKACS |
| First Name Of The Provider | ZSOLT |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2705 N LEBANON ST |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | LEBANON |
| Zip Code Of The Provider | 460528612 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 1092.5 |
| Number Of Medicare Beneficiaries | 204 |
| Total Submitted Charge Amount | 79477 |
| Total Medicare Allowed Amount | 48396.18 |
| Total Medicare Payment Amount | 34144.88 |
| Total Medicare Standardized Payment Amount | 36612.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 152.5 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 4338 |
| Total Drug Medicare AllowedAmount | 1775.9 |
| Total Drug Medicare PaymentAmount | 1668.02 |
| Total Drug Medicare Standardized Payment Amount | 1668.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 940 |
| Number Of Medicare Beneficiaries With Medical Services | 204 |
| Total Medical Submitted Charge Amount | 75139 |
| Total Medical Medicare Allowed Amount | 46620.28 |
| Total Medical Medicare Payment Amount | 32476.86 |
| Total Medical Medicare Standardized Payment Amount | 34943.99 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 84 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 114 |
| Number Of Male Beneficiaries | 90 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 154 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 50 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1174 |