| National Provider Identifier [NPI]: | 1194789354 |
| Last Name Of The Provider | PRENTICE |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19001 OLD LAGRANGE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOKENA |
| Zip Code Of The Provider | 604488012 |
| 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 | 56 |
| Number Of Services | 7448 |
| Number Of Medicare Beneficiaries | 2583 |
| Total Submitted Charge Amount | 1049881.25 |
| Total Medicare Allowed Amount | 488644.64 |
| Total Medicare Payment Amount | 369909.87 |
| Total Medicare Standardized Payment Amount | 348679.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 324 |
| Number Of Medicare Beneficiaries With Drug Services | 82 |
| Total Drug Submitted ChargeAmount | 32032.25 |
| Total Drug Medicare AllowedAmount | 16936.95 |
| Total Drug Medicare PaymentAmount | 13136.23 |
| Total Drug Medicare Standardized Payment Amount | 13136.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 7124 |
| Number Of Medicare Beneficiaries With Medical Services | 2583 |
| Total Medical Submitted Charge Amount | 1017849 |
| Total Medical Medicare Allowed Amount | 471707.69 |
| Total Medical Medicare Payment Amount | 356773.64 |
| Total Medical Medicare Standardized Payment Amount | 335543.6 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 121 |
| Number Of Beneficiaries Age 65 to 74 | 894 |
| Number Of Beneficiaries Age 75 to 84 | 946 |
| Number Of Beneficiaries Age Greater 84 | 622 |
| Number Of Female Beneficiaries | 1296 |
| Number Of Male Beneficiaries | 1287 |
| Number Of Non Hispanic White Beneficiaries | 2434 |
| Number Of Black or African American Beneficiaries | 54 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 58 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2387 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 196 |
| Percent Of With Atrial Fibrillation | 45 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 74 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7759 |