| National Provider Identifier [NPI]: | 1699850610 |
| Last Name Of The Provider | IMLACH |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4001 VOLLMER RD. |
| Street Address 2 Of The Provider | |
| City Of The Provider | OLYMPIA FIELDS |
| Zip Code Of The Provider | 604611073 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 3559 |
| Number Of Medicare Beneficiaries | 563 |
| Total Submitted Charge Amount | 368940 |
| Total Medicare Allowed Amount | 212940.85 |
| Total Medicare Payment Amount | 148060.07 |
| Total Medicare Standardized Payment Amount | 142489.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 20 |
| Number Of Drug Services | 650 |
| Number Of Medicare Beneficiaries With Drug Services | 228 |
| Total Drug Submitted ChargeAmount | 21939 |
| Total Drug Medicare AllowedAmount | 10086.88 |
| Total Drug Medicare PaymentAmount | 8979.04 |
| Total Drug Medicare Standardized Payment Amount | 8979.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 2909 |
| Number Of Medicare Beneficiaries With Medical Services | 563 |
| Total Medical Submitted Charge Amount | 347001 |
| Total Medical Medicare Allowed Amount | 202853.97 |
| Total Medical Medicare Payment Amount | 139081.03 |
| Total Medical Medicare Standardized Payment Amount | 133510.33 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 122 |
| Number Of Beneficiaries Age 65 to 74 | 258 |
| Number Of Beneficiaries Age 75 to 84 | 136 |
| Number Of Beneficiaries Age Greater 84 | 47 |
| Number Of Female Beneficiaries | 277 |
| Number Of Male Beneficiaries | 286 |
| Number Of Non Hispanic White Beneficiaries | 325 |
| Number Of Black or African American Beneficiaries | 218 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 448 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 115 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2168 |