| National Provider Identifier [NPI]: | 1033167846 |
| Last Name Of The Provider | VISCONTI |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4000 N ILLINOIS LN |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | SWANSEA |
| Zip Code Of The Provider | 622261969 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 107 |
| Number Of Services | 83783 |
| Number Of Medicare Beneficiaries | 759 |
| Total Submitted Charge Amount | 5239085 |
| Total Medicare Allowed Amount | 2080678.76 |
| Total Medicare Payment Amount | 1619986.8 |
| Total Medicare Standardized Payment Amount | 1613814 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 70 |
| Number Of Drug Services | 79181 |
| Number Of Medicare Beneficiaries With Drug Services | 212 |
| Total Drug Submitted ChargeAmount | 4482570 |
| Total Drug Medicare AllowedAmount | 1739838.63 |
| Total Drug Medicare PaymentAmount | 1360654.25 |
| Total Drug Medicare Standardized Payment Amount | 1360654.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 4602 |
| Number Of Medicare Beneficiaries With Medical Services | 758 |
| Total Medical Submitted Charge Amount | 756515 |
| Total Medical Medicare Allowed Amount | 340840.13 |
| Total Medical Medicare Payment Amount | 259332.55 |
| Total Medical Medicare Standardized Payment Amount | 253159.75 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 135 |
| Number Of Beneficiaries Age 65 to 74 | 289 |
| Number Of Beneficiaries Age 75 to 84 | 238 |
| Number Of Beneficiaries Age Greater 84 | 97 |
| Number Of Female Beneficiaries | 404 |
| Number Of Male Beneficiaries | 355 |
| Number Of Non Hispanic White Beneficiaries | 597 |
| Number Of Black or African American Beneficiaries | 146 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 568 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 191 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 49 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 2.1732 |