| National Provider Identifier [NPI]: | 1578582532 |
| Last Name Of The Provider | DOMIANO |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2800 W 95TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | EVERGREEN |
| Zip Code Of The Provider | 60805 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 172 |
| Number Of Services | 5664 |
| Number Of Medicare Beneficiaries | 3321 |
| Total Submitted Charge Amount | 1286522 |
| Total Medicare Allowed Amount | 211246.65 |
| Total Medicare Payment Amount | 159153.41 |
| Total Medicare Standardized Payment Amount | 150771.73 |
| 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 | 172 |
| Number Of Medical Services | 5664 |
| Number Of Medicare Beneficiaries With Medical Services | 3321 |
| Total Medical Submitted Charge Amount | 1286522 |
| Total Medical Medicare Allowed Amount | 211246.65 |
| Total Medical Medicare Payment Amount | 159153.41 |
| Total Medical Medicare Standardized Payment Amount | 150771.73 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 452 |
| Number Of Beneficiaries Age 65 to 74 | 1127 |
| Number Of Beneficiaries Age 75 to 84 | 1095 |
| Number Of Beneficiaries Age Greater 84 | 647 |
| Number Of Female Beneficiaries | 2019 |
| Number Of Male Beneficiaries | 1302 |
| Number Of Non Hispanic White Beneficiaries | 1667 |
| Number Of Black or African American Beneficiaries | 1494 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 132 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2429 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 892 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9293 |