| National Provider Identifier [NPI]: | 1659553543 |
| Last Name Of The Provider | MAK |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 N 1ST ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 627023719 |
| 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 | 86 |
| Number Of Services | 2605 |
| Number Of Medicare Beneficiaries | 786 |
| Total Submitted Charge Amount | 270615.11 |
| Total Medicare Allowed Amount | 240264.29 |
| Total Medicare Payment Amount | 184886.19 |
| Total Medicare Standardized Payment Amount | 190122.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 200 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 11573.88 |
| Total Drug Medicare AllowedAmount | 10588.99 |
| Total Drug Medicare PaymentAmount | 8301.65 |
| Total Drug Medicare Standardized Payment Amount | 8301.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 2405 |
| Number Of Medicare Beneficiaries With Medical Services | 786 |
| Total Medical Submitted Charge Amount | 259041.23 |
| Total Medical Medicare Allowed Amount | 229675.3 |
| Total Medical Medicare Payment Amount | 176584.54 |
| Total Medical Medicare Standardized Payment Amount | 181820.44 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 226 |
| Number Of Beneficiaries Age 75 to 84 | 280 |
| Number Of Beneficiaries Age Greater 84 | 203 |
| Number Of Female Beneficiaries | 371 |
| Number Of Male Beneficiaries | 415 |
| Number Of Non Hispanic White Beneficiaries | 745 |
| Number Of Black or African American Beneficiaries | 25 |
| 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 | 682 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 40 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.72 |