| National Provider Identifier [NPI]: | 1518946656 |
| Last Name Of The Provider | BENDITZSON |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 E WASHINGTON ST |
| Street Address 2 Of The Provider | SUITE 2903 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606022103 |
| 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 | 9 |
| Number Of Services | 193 |
| Number Of Medicare Beneficiaries | 52 |
| Total Submitted Charge Amount | 21482.57 |
| Total Medicare Allowed Amount | 18311.21 |
| Total Medicare Payment Amount | 12767.71 |
| Total Medicare Standardized Payment Amount | 13896.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 1650 |
| Total Drug Medicare AllowedAmount | 582.9 |
| Total Drug Medicare PaymentAmount | 571.26 |
| Total Drug Medicare Standardized Payment Amount | 571.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 7 |
| Number Of Medical Services | 169 |
| Number Of Medicare Beneficiaries With Medical Services | 51 |
| Total Medical Submitted Charge Amount | 19832.57 |
| Total Medical Medicare Allowed Amount | 17728.31 |
| Total Medical Medicare Payment Amount | 12196.45 |
| Total Medical Medicare Standardized Payment Amount | 13325.19 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 27 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 24 |
| Number Of Male Beneficiaries | 28 |
| Number Of Non Hispanic White Beneficiaries | 38 |
| 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 | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 52 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 0 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | 27 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6745 |