| National Provider Identifier [NPI]: | 1790780765 |
| Last Name Of The Provider | PEIKEN |
| First Name Of The Provider | MARVIN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5999 NEW WILKE RD |
| Street Address 2 Of The Provider | SUITE 200 BLDG 2 |
| City Of The Provider | ROLLING MEADOWS |
| Zip Code Of The Provider | 600084506 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 4280 |
| Number Of Medicare Beneficiaries | 790 |
| Total Submitted Charge Amount | 404873 |
| Total Medicare Allowed Amount | 231512.79 |
| Total Medicare Payment Amount | 167613.47 |
| Total Medicare Standardized Payment Amount | 158580.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 574 |
| Number Of Medicare Beneficiaries With Drug Services | 189 |
| Total Drug Submitted ChargeAmount | 21335 |
| Total Drug Medicare AllowedAmount | 11031.63 |
| Total Drug Medicare PaymentAmount | 9825.49 |
| Total Drug Medicare Standardized Payment Amount | 9825.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 3706 |
| Number Of Medicare Beneficiaries With Medical Services | 790 |
| Total Medical Submitted Charge Amount | 383538 |
| Total Medical Medicare Allowed Amount | 220481.16 |
| Total Medical Medicare Payment Amount | 157787.98 |
| Total Medical Medicare Standardized Payment Amount | 148754.61 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 294 |
| Number Of Beneficiaries Age 75 to 84 | 311 |
| Number Of Beneficiaries Age Greater 84 | 160 |
| Number Of Female Beneficiaries | 478 |
| Number Of Male Beneficiaries | 312 |
| Number Of Non Hispanic White Beneficiaries | 766 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 766 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.0482 |