| National Provider Identifier [NPI]: | 1720035132 |
| Last Name Of The Provider | MANGURTEN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3405 N ARLINGTON HEIGHTS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ARLINGTON HEIGHTS |
| Zip Code Of The Provider | 600041536 |
| 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 | 76 |
| Number Of Services | 7398 |
| Number Of Medicare Beneficiaries | 449 |
| Total Submitted Charge Amount | 417090 |
| Total Medicare Allowed Amount | 261731.63 |
| Total Medicare Payment Amount | 207295.61 |
| Total Medicare Standardized Payment Amount | 201788.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 218 |
| Number Of Medicare Beneficiaries With Drug Services | 144 |
| Total Drug Submitted ChargeAmount | 8675 |
| Total Drug Medicare AllowedAmount | 4841.09 |
| Total Drug Medicare PaymentAmount | 4636.24 |
| Total Drug Medicare Standardized Payment Amount | 4636.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 7180 |
| Number Of Medicare Beneficiaries With Medical Services | 449 |
| Total Medical Submitted Charge Amount | 408415 |
| Total Medical Medicare Allowed Amount | 256890.54 |
| Total Medical Medicare Payment Amount | 202659.37 |
| Total Medical Medicare Standardized Payment Amount | 197151.96 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 228 |
| Number Of Beneficiaries Age 75 to 84 | 163 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 229 |
| Number Of Male Beneficiaries | 220 |
| Number Of Non Hispanic White Beneficiaries | 433 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8737 |