| National Provider Identifier [NPI]: | 1447450788 |
| Last Name Of The Provider | SUR |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19001 OLD LAGRANGE ROAD |
| Street Address 2 Of The Provider | HEART CARE CENTERS OF ILLINOIS, S.C. |
| City Of The Provider | MOKENA |
| Zip Code Of The Provider | 604488012 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 111 |
| Number Of Services | 4612 |
| Number Of Medicare Beneficiaries | 1912 |
| Total Submitted Charge Amount | 1579889.4 |
| Total Medicare Allowed Amount | 512000.66 |
| Total Medicare Payment Amount | 392911.15 |
| Total Medicare Standardized Payment Amount | 369111.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 335 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 33500 |
| Total Drug Medicare AllowedAmount | 17726.98 |
| Total Drug Medicare PaymentAmount | 13897.87 |
| Total Drug Medicare Standardized Payment Amount | 13897.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 110 |
| Number Of Medical Services | 4277 |
| Number Of Medicare Beneficiaries With Medical Services | 1912 |
| Total Medical Submitted Charge Amount | 1546389.4 |
| Total Medical Medicare Allowed Amount | 494273.68 |
| Total Medical Medicare Payment Amount | 379013.28 |
| Total Medical Medicare Standardized Payment Amount | 355213.8 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 191 |
| Number Of Beneficiaries Age 65 to 74 | 661 |
| Number Of Beneficiaries Age 75 to 84 | 658 |
| Number Of Beneficiaries Age Greater 84 | 402 |
| Number Of Female Beneficiaries | 1023 |
| Number Of Male Beneficiaries | 889 |
| Number Of Non Hispanic White Beneficiaries | 1446 |
| Number Of Black or African American Beneficiaries | 359 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 85 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1574 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 338 |
| Percent Of With Atrial Fibrillation | 39 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 62 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.0712 |