| National Provider Identifier [NPI]: | 1851387955 |
| Last Name Of The Provider | HINES |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2923 N CALIFORNIA AVE |
| Street Address 2 Of The Provider | STE 220 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606187702 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 77934 |
| Number Of Medicare Beneficiaries | 1030 |
| Total Submitted Charge Amount | 2288268.58 |
| Total Medicare Allowed Amount | 1141681.89 |
| Total Medicare Payment Amount | 877003.94 |
| Total Medicare Standardized Payment Amount | 862575.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 75270 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 1602504.98 |
| Total Drug Medicare AllowedAmount | 811542.43 |
| Total Drug Medicare PaymentAmount | 625549.05 |
| Total Drug Medicare Standardized Payment Amount | 625549.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 2664 |
| Number Of Medicare Beneficiaries With Medical Services | 1030 |
| Total Medical Submitted Charge Amount | 685763.6 |
| Total Medical Medicare Allowed Amount | 330139.46 |
| Total Medical Medicare Payment Amount | 251454.89 |
| Total Medical Medicare Standardized Payment Amount | 237026.24 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 296 |
| Number Of Beneficiaries Age 65 to 74 | 308 |
| Number Of Beneficiaries Age 75 to 84 | 255 |
| Number Of Beneficiaries Age Greater 84 | 171 |
| Number Of Female Beneficiaries | 538 |
| Number Of Male Beneficiaries | 492 |
| Number Of Non Hispanic White Beneficiaries | 490 |
| Number Of Black or African American Beneficiaries | 350 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 172 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 419 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 611 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 38 |
| Percent Of With Asthma | 22 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 66 |
| Percent Of With Chronic Kidney Disease | 69 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 45 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 66 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 3.7093 |