| National Provider Identifier [NPI]: | 1053339499 |
| Last Name Of The Provider | NORA |
| First Name Of The Provider | MARYANNETTE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6969 N LINCOLN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LINCOLNWOOD |
| Zip Code Of The Provider | 607122527 |
| 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 | 53 |
| Number Of Services | 4311 |
| Number Of Medicare Beneficiaries | 477 |
| Total Submitted Charge Amount | 337718.1 |
| Total Medicare Allowed Amount | 243031.31 |
| Total Medicare Payment Amount | 174773.09 |
| Total Medicare Standardized Payment Amount | 164476.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 225 |
| Number Of Medicare Beneficiaries With Drug Services | 201 |
| Total Drug Submitted ChargeAmount | 6453 |
| Total Drug Medicare AllowedAmount | 4043.87 |
| Total Drug Medicare PaymentAmount | 3940.57 |
| Total Drug Medicare Standardized Payment Amount | 3940.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 4086 |
| Number Of Medicare Beneficiaries With Medical Services | 477 |
| Total Medical Submitted Charge Amount | 331265.1 |
| Total Medical Medicare Allowed Amount | 238987.44 |
| Total Medical Medicare Payment Amount | 170832.52 |
| Total Medical Medicare Standardized Payment Amount | 160536.2 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 207 |
| Number Of Beneficiaries Age 75 to 84 | 160 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 351 |
| Number Of Male Beneficiaries | 126 |
| Number Of Non Hispanic White Beneficiaries | 396 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 394 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 83 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1232 |