| National Provider Identifier [NPI]: | 1013972850 |
| Last Name Of The Provider | LICHTENBERG |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3231 EUCLID AVE |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | BERWYN |
| Zip Code Of The Provider | 604023471 |
| 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 | 49 |
| Number Of Services | 3337 |
| Number Of Medicare Beneficiaries | 1328 |
| Total Submitted Charge Amount | 794751 |
| Total Medicare Allowed Amount | 277536.98 |
| Total Medicare Payment Amount | 202571.46 |
| Total Medicare Standardized Payment Amount | 194828.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 400 |
| Number Of Medicare Beneficiaries With Drug Services | 100 |
| Total Drug Submitted ChargeAmount | 40000 |
| Total Drug Medicare AllowedAmount | 21234.54 |
| Total Drug Medicare PaymentAmount | 16386.23 |
| Total Drug Medicare Standardized Payment Amount | 16386.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 2937 |
| Number Of Medicare Beneficiaries With Medical Services | 1328 |
| Total Medical Submitted Charge Amount | 754751 |
| Total Medical Medicare Allowed Amount | 256302.44 |
| Total Medical Medicare Payment Amount | 186185.23 |
| Total Medical Medicare Standardized Payment Amount | 178442.24 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 195 |
| Number Of Beneficiaries Age 65 to 74 | 414 |
| Number Of Beneficiaries Age 75 to 84 | 421 |
| Number Of Beneficiaries Age Greater 84 | 298 |
| Number Of Female Beneficiaries | 717 |
| Number Of Male Beneficiaries | 611 |
| Number Of Non Hispanic White Beneficiaries | 886 |
| Number Of Black or African American Beneficiaries | 134 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 275 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 880 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 448 |
| Percent Of With Atrial Fibrillation | 34 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9074 |