| National Provider Identifier [NPI]: | 1295737088 |
| Last Name Of The Provider | DEJESUS |
| First Name Of The Provider | ERNEST |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 25 WINFIELD ROAD |
| Street Address 2 Of The Provider | SUITE 414 |
| City Of The Provider | WINFIELD |
| Zip Code Of The Provider | 60190 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 17243 |
| Number Of Medicare Beneficiaries | 856 |
| Total Submitted Charge Amount | 2693853 |
| Total Medicare Allowed Amount | 955685.43 |
| Total Medicare Payment Amount | 737331.26 |
| Total Medicare Standardized Payment Amount | 696282.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 12809 |
| Number Of Medicare Beneficiaries With Drug Services | 174 |
| Total Drug Submitted ChargeAmount | 56664 |
| Total Drug Medicare AllowedAmount | 23406.57 |
| Total Drug Medicare PaymentAmount | 18121.98 |
| Total Drug Medicare Standardized Payment Amount | 18121.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 4434 |
| Number Of Medicare Beneficiaries With Medical Services | 856 |
| Total Medical Submitted Charge Amount | 2637189 |
| Total Medical Medicare Allowed Amount | 932278.86 |
| Total Medical Medicare Payment Amount | 719209.28 |
| Total Medical Medicare Standardized Payment Amount | 678160.54 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 193 |
| Number Of Beneficiaries Age 65 to 74 | 276 |
| Number Of Beneficiaries Age 75 to 84 | 240 |
| Number Of Beneficiaries Age Greater 84 | 147 |
| Number Of Female Beneficiaries | 411 |
| Number Of Male Beneficiaries | 445 |
| Number Of Non Hispanic White Beneficiaries | 601 |
| Number Of Black or African American Beneficiaries | 96 |
| Number Of AsianPacific Islander Beneficiaries | 54 |
| Number Of Hispanic Beneficiaries | 83 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 620 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 236 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 57 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 60 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 4.4679 |