| National Provider Identifier [NPI]: | 1922080399 |
| Last Name Of The Provider | BREIT |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1800 HOLLISTER DR |
| Street Address 2 Of The Provider | SUITE G-18 |
| City Of The Provider | LIBERTYVILLE |
| Zip Code Of The Provider | 600485263 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 1114 |
| Number Of Medicare Beneficiaries | 780 |
| Total Submitted Charge Amount | 461854 |
| Total Medicare Allowed Amount | 97746.22 |
| Total Medicare Payment Amount | 72827.4 |
| Total Medicare Standardized Payment Amount | 70646.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 96 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 9313 |
| Total Drug Medicare AllowedAmount | 213.48 |
| Total Drug Medicare PaymentAmount | 167.33 |
| Total Drug Medicare Standardized Payment Amount | 167.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 1018 |
| Number Of Medicare Beneficiaries With Medical Services | 778 |
| Total Medical Submitted Charge Amount | 452541 |
| Total Medical Medicare Allowed Amount | 97532.74 |
| Total Medical Medicare Payment Amount | 72660.07 |
| Total Medical Medicare Standardized Payment Amount | 70478.73 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 331 |
| Number Of Beneficiaries Age 75 to 84 | 248 |
| Number Of Beneficiaries Age Greater 84 | 126 |
| Number Of Female Beneficiaries | 481 |
| Number Of Male Beneficiaries | 299 |
| Number Of Non Hispanic White Beneficiaries | 676 |
| Number Of Black or African American Beneficiaries | 52 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 704 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 76 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 1.2112 |