| National Provider Identifier [NPI]: | 1629032958 |
| Last Name Of The Provider | KACZMAREK |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4905 OLD ORCHARD CTR |
| Street Address 2 Of The Provider | LOWER LEVEL |
| City Of The Provider | SKOKIE |
| Zip Code Of The Provider | 600771425 |
| 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 | 65 |
| Number Of Services | 2392 |
| Number Of Medicare Beneficiaries | 376 |
| Total Submitted Charge Amount | 328805 |
| Total Medicare Allowed Amount | 134756.75 |
| Total Medicare Payment Amount | 99694.22 |
| Total Medicare Standardized Payment Amount | 94428.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 167 |
| Number Of Medicare Beneficiaries With Drug Services | 125 |
| Total Drug Submitted ChargeAmount | 7376 |
| Total Drug Medicare AllowedAmount | 5402.16 |
| Total Drug Medicare PaymentAmount | 5273.58 |
| Total Drug Medicare Standardized Payment Amount | 5273.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 2225 |
| Number Of Medicare Beneficiaries With Medical Services | 376 |
| Total Medical Submitted Charge Amount | 321429 |
| Total Medical Medicare Allowed Amount | 129354.59 |
| Total Medical Medicare Payment Amount | 94420.64 |
| Total Medical Medicare Standardized Payment Amount | 89155.3 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 160 |
| Number Of Beneficiaries Age 75 to 84 | 149 |
| Number Of Beneficiaries Age Greater 84 | 56 |
| Number Of Female Beneficiaries | 214 |
| Number Of Male Beneficiaries | 162 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9621 |