| National Provider Identifier [NPI]: | 1750393328 |
| Last Name Of The Provider | AFRICANO |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | C.R.N.A. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19624 GOVERNORS HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | FLOSSMOOR |
| Zip Code Of The Provider | 604222077 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | CRNA |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 5 |
| Number Of Services | 1402 |
| Number Of Medicare Beneficiaries | 1359 |
| Total Submitted Charge Amount | 349840.35 |
| Total Medicare Allowed Amount | 243024.96 |
| Total Medicare Payment Amount | 187897.2 |
| Total Medicare Standardized Payment Amount | 177168.34 |
| 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 | 5 |
| Number Of Medical Services | 1402 |
| Number Of Medicare Beneficiaries With Medical Services | 1359 |
| Total Medical Submitted Charge Amount | 349840.35 |
| Total Medical Medicare Allowed Amount | 243024.96 |
| Total Medical Medicare Payment Amount | 187897.2 |
| Total Medical Medicare Standardized Payment Amount | 177168.34 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 184 |
| Number Of Beneficiaries Age 65 to 74 | 732 |
| Number Of Beneficiaries Age 75 to 84 | 383 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 799 |
| Number Of Male Beneficiaries | 560 |
| Number Of Non Hispanic White Beneficiaries | 953 |
| Number Of Black or African American Beneficiaries | 345 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1145 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 214 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0572 |