| National Provider Identifier [NPI]: | 1497729537 |
| Last Name Of The Provider | GAWNE |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 885 ROOSEVELT RD |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | GLEN ELLYN |
| Zip Code Of The Provider | 601376141 |
| 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 | 30 |
| Number Of Services | 1069 |
| Number Of Medicare Beneficiaries | 265 |
| Total Submitted Charge Amount | 166684.68 |
| Total Medicare Allowed Amount | 93487.19 |
| Total Medicare Payment Amount | 71082.08 |
| Total Medicare Standardized Payment Amount | 68395.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 124 |
| Number Of Medicare Beneficiaries With Drug Services | 89 |
| Total Drug Submitted ChargeAmount | 10063.68 |
| Total Drug Medicare AllowedAmount | 5854.39 |
| Total Drug Medicare PaymentAmount | 5717.05 |
| Total Drug Medicare Standardized Payment Amount | 5717.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 945 |
| Number Of Medicare Beneficiaries With Medical Services | 265 |
| Total Medical Submitted Charge Amount | 156621 |
| Total Medical Medicare Allowed Amount | 87632.8 |
| Total Medical Medicare Payment Amount | 65365.03 |
| Total Medical Medicare Standardized Payment Amount | 62678.06 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 87 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 142 |
| Number Of Male Beneficiaries | 123 |
| Number Of Non Hispanic White Beneficiaries | 241 |
| Number Of Black or African American Beneficiaries | |
| 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 | 237 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9208 |