| National Provider Identifier [NPI]: | 1417931510 |
| Last Name Of The Provider | VIRCHOW |
| First Name Of The Provider | JAY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 BIESTERFIELD RD |
| Street Address 2 Of The Provider | SUITE 206 |
| City Of The Provider | ELK GROVE VILLAGE |
| Zip Code Of The Provider | 600073361 |
| 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 | 41 |
| Number Of Services | 769 |
| Number Of Medicare Beneficiaries | 183 |
| Total Submitted Charge Amount | 76237 |
| Total Medicare Allowed Amount | 51678.57 |
| Total Medicare Payment Amount | 35245.4 |
| Total Medicare Standardized Payment Amount | 33100.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 69 |
| Number Of Medicare Beneficiaries With Drug Services | 59 |
| Total Drug Submitted ChargeAmount | 3457 |
| Total Drug Medicare AllowedAmount | 2525.72 |
| Total Drug Medicare PaymentAmount | 2465.76 |
| Total Drug Medicare Standardized Payment Amount | 2465.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 700 |
| Number Of Medicare Beneficiaries With Medical Services | 183 |
| Total Medical Submitted Charge Amount | 72780 |
| Total Medical Medicare Allowed Amount | 49152.85 |
| Total Medical Medicare Payment Amount | 32779.64 |
| Total Medical Medicare Standardized Payment Amount | 30634.48 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 96 |
| Number Of Beneficiaries Age 75 to 84 | 47 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 99 |
| Number Of Male Beneficiaries | 84 |
| Number Of Non Hispanic White Beneficiaries | 164 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9316 |