| National Provider Identifier [NPI]: | 1891877213 |
| Last Name Of The Provider | DAVE |
| First Name Of The Provider | AMARISH |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2000 LAKE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WOODSTOCK |
| Zip Code Of The Provider | 600987401 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 4244 |
| Number Of Medicare Beneficiaries | 469 |
| Total Submitted Charge Amount | 216838.81 |
| Total Medicare Allowed Amount | 166447.85 |
| Total Medicare Payment Amount | 120619.2 |
| Total Medicare Standardized Payment Amount | 125209.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2049 |
| Number Of Medicare Beneficiaries With Drug Services | 96 |
| Total Drug Submitted ChargeAmount | 18878 |
| Total Drug Medicare AllowedAmount | 2433.47 |
| Total Drug Medicare PaymentAmount | 1803.04 |
| Total Drug Medicare Standardized Payment Amount | 1803.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 2195 |
| Number Of Medicare Beneficiaries With Medical Services | 469 |
| Total Medical Submitted Charge Amount | 197960.81 |
| Total Medical Medicare Allowed Amount | 164014.38 |
| Total Medical Medicare Payment Amount | 118816.16 |
| Total Medical Medicare Standardized Payment Amount | 123406.18 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 116 |
| Number Of Beneficiaries Age 65 to 74 | 176 |
| Number Of Beneficiaries Age 75 to 84 | 126 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 282 |
| Number Of Male Beneficiaries | 187 |
| Number Of Non Hispanic White Beneficiaries | 430 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 381 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 88 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.2857 |