| National Provider Identifier [NPI]: | 1215044508 |
| Last Name Of The Provider | DEBRE |
| First Name Of The Provider | MICHAEL |
| 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 | 11600 S KEDZIE AVE |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | MERRIONETTE PARK |
| Zip Code Of The Provider | 608036307 |
| 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 | 40 |
| Number Of Services | 2639 |
| Number Of Medicare Beneficiaries | 731 |
| Total Submitted Charge Amount | 383025 |
| Total Medicare Allowed Amount | 243796.85 |
| Total Medicare Payment Amount | 173736.45 |
| Total Medicare Standardized Payment Amount | 163825.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 233 |
| Number Of Medicare Beneficiaries With Drug Services | 214 |
| Total Drug Submitted ChargeAmount | 8370 |
| Total Drug Medicare AllowedAmount | 7365.51 |
| Total Drug Medicare PaymentAmount | 7154.99 |
| Total Drug Medicare Standardized Payment Amount | 7154.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 2406 |
| Number Of Medicare Beneficiaries With Medical Services | 731 |
| Total Medical Submitted Charge Amount | 374655 |
| Total Medical Medicare Allowed Amount | 236431.34 |
| Total Medical Medicare Payment Amount | 166581.46 |
| Total Medical Medicare Standardized Payment Amount | 156670.13 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 248 |
| Number Of Beneficiaries Age 75 to 84 | 278 |
| Number Of Beneficiaries Age Greater 84 | 170 |
| Number Of Female Beneficiaries | 437 |
| Number Of Male Beneficiaries | 294 |
| Number Of Non Hispanic White Beneficiaries | 663 |
| Number Of Black or African American Beneficiaries | 38 |
| 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 | 697 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.036 |