| National Provider Identifier [NPI]: | 1487638805 |
| Last Name Of The Provider | BLANCO |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9401 S PULASKI RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | EVERGREEN PARK |
| Zip Code Of The Provider | 608051924 |
| 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 | 30 |
| Number Of Services | 3164 |
| Number Of Medicare Beneficiaries | 1645 |
| Total Submitted Charge Amount | 531660 |
| Total Medicare Allowed Amount | 158076.58 |
| Total Medicare Payment Amount | 112604.8 |
| Total Medicare Standardized Payment Amount | 107981.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 30 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 1050 |
| Total Drug Medicare AllowedAmount | 257.4 |
| Total Drug Medicare PaymentAmount | 252.3 |
| Total Drug Medicare Standardized Payment Amount | 252.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 3134 |
| Number Of Medicare Beneficiaries With Medical Services | 1645 |
| Total Medical Submitted Charge Amount | 530610 |
| Total Medical Medicare Allowed Amount | 157819.18 |
| Total Medical Medicare Payment Amount | 112352.5 |
| Total Medical Medicare Standardized Payment Amount | 107729.29 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 312 |
| Number Of Beneficiaries Age 65 to 74 | 545 |
| Number Of Beneficiaries Age 75 to 84 | 464 |
| Number Of Beneficiaries Age Greater 84 | 324 |
| Number Of Female Beneficiaries | 984 |
| Number Of Male Beneficiaries | 661 |
| Number Of Non Hispanic White Beneficiaries | 311 |
| Number Of Black or African American Beneficiaries | 1048 |
| Number Of AsianPacific Islander Beneficiaries | 137 |
| Number Of Hispanic Beneficiaries | 135 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 709 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 936 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.1905 |