| National Provider Identifier [NPI]: | 1891891636 |
| Last Name Of The Provider | HEIM |
| First Name Of The Provider | DENNIS |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1770 E LAKE SHORE DR |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 625213832 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 2690 |
| Number Of Medicare Beneficiaries | 521 |
| Total Submitted Charge Amount | 151516.97 |
| Total Medicare Allowed Amount | 137093.11 |
| Total Medicare Payment Amount | 88390.84 |
| Total Medicare Standardized Payment Amount | 93660.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 183 |
| Number Of Medicare Beneficiaries With Drug Services | 138 |
| Total Drug Submitted ChargeAmount | 3776.26 |
| Total Drug Medicare AllowedAmount | 3568.04 |
| Total Drug Medicare PaymentAmount | 2985.3 |
| Total Drug Medicare Standardized Payment Amount | 2985.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 2507 |
| Number Of Medicare Beneficiaries With Medical Services | 521 |
| Total Medical Submitted Charge Amount | 147740.71 |
| Total Medical Medicare Allowed Amount | 133525.07 |
| Total Medical Medicare Payment Amount | 85405.54 |
| Total Medical Medicare Standardized Payment Amount | 90675.4 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 229 |
| Number Of Beneficiaries Age 75 to 84 | 151 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 292 |
| Number Of Male Beneficiaries | 229 |
| Number Of Non Hispanic White Beneficiaries | 506 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 478 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9809 |