| National Provider Identifier [NPI]: | 1770610248 |
| Last Name Of The Provider | WIESKA |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.,S. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 GRAND CANYON PKWY |
| Street Address 2 Of The Provider | STE 301 |
| City Of The Provider | HOFFMAN ESTATES |
| Zip Code Of The Provider | 601941705 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Audiologist (billing independently) |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 6 |
| Number Of Services | 634 |
| Number Of Medicare Beneficiaries | 308 |
| Total Submitted Charge Amount | 37525 |
| Total Medicare Allowed Amount | 18151.74 |
| Total Medicare Payment Amount | 13438.58 |
| Total Medicare Standardized Payment Amount | 12806.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 6 |
| Number Of Medical Services | 634 |
| Number Of Medicare Beneficiaries With Medical Services | 308 |
| Total Medical Submitted Charge Amount | 37525 |
| Total Medical Medicare Allowed Amount | 18151.74 |
| Total Medical Medicare Payment Amount | 13438.58 |
| Total Medical Medicare Standardized Payment Amount | 12806.29 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 132 |
| Number Of Beneficiaries Age 75 to 84 | 108 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 170 |
| Number Of Male Beneficiaries | 138 |
| Number Of Non Hispanic White Beneficiaries | 267 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| 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 | 290 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1021 |