| National Provider Identifier [NPI]: | 1811942600 |
| Last Name Of The Provider | STOBNICKI |
| First Name Of The Provider | MAREK |
| Middle Initial Of The Provider | Z |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7900 N MILWAUKEE AVE |
| Street Address 2 Of The Provider | SUITE 17 |
| City Of The Provider | NILES |
| Zip Code Of The Provider | 607143159 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 106 |
| Number Of Services | 7803 |
| Number Of Medicare Beneficiaries | 1267 |
| Total Submitted Charge Amount | 2728804 |
| Total Medicare Allowed Amount | 614917.7 |
| Total Medicare Payment Amount | 459505.7 |
| Total Medicare Standardized Payment Amount | 436792.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 1727 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 476464 |
| Total Drug Medicare AllowedAmount | 120728.01 |
| Total Drug Medicare PaymentAmount | 92382.3 |
| Total Drug Medicare Standardized Payment Amount | 92382.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 6076 |
| Number Of Medicare Beneficiaries With Medical Services | 1267 |
| Total Medical Submitted Charge Amount | 2252340 |
| Total Medical Medicare Allowed Amount | 494189.69 |
| Total Medical Medicare Payment Amount | 367123.4 |
| Total Medical Medicare Standardized Payment Amount | 344410.64 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 434 |
| Number Of Beneficiaries Age 75 to 84 | 463 |
| Number Of Beneficiaries Age Greater 84 | 293 |
| Number Of Female Beneficiaries | 310 |
| Number Of Male Beneficiaries | 957 |
| Number Of Non Hispanic White Beneficiaries | 1197 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 995 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 272 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4585 |