| National Provider Identifier [NPI]: | 1558357830 |
| Last Name Of The Provider | WAITLEY |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 901 MCCLINTOCK DR |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | BURR RIDGE |
| Zip Code Of The Provider | 605270872 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 15267 |
| Number Of Medicare Beneficiaries | 809 |
| Total Submitted Charge Amount | 600423.18 |
| Total Medicare Allowed Amount | 282806.04 |
| Total Medicare Payment Amount | 217704.93 |
| Total Medicare Standardized Payment Amount | 206270.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 12665 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 68985.18 |
| Total Drug Medicare AllowedAmount | 25046.16 |
| Total Drug Medicare PaymentAmount | 19663.25 |
| Total Drug Medicare Standardized Payment Amount | 19663.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 2602 |
| Number Of Medicare Beneficiaries With Medical Services | 809 |
| Total Medical Submitted Charge Amount | 531438 |
| Total Medical Medicare Allowed Amount | 257759.88 |
| Total Medical Medicare Payment Amount | 198041.68 |
| Total Medical Medicare Standardized Payment Amount | 186607.72 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 108 |
| Number Of Beneficiaries Age 65 to 74 | 221 |
| Number Of Beneficiaries Age 75 to 84 | 256 |
| Number Of Beneficiaries Age Greater 84 | 224 |
| Number Of Female Beneficiaries | 446 |
| Number Of Male Beneficiaries | 363 |
| Number Of Non Hispanic White Beneficiaries | 685 |
| Number Of Black or African American Beneficiaries | 34 |
| Number Of AsianPacific Islander Beneficiaries | 37 |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 625 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 184 |
| Percent Of With Atrial Fibrillation | 34 |
| Percent Of With Alzheimers Disease or Dementia | 38 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 56 |
| Percent Of With Chronic Kidney Disease | 69 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 20 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 3.1023 |