| National Provider Identifier [NPI]: | 1871531103 |
| Last Name Of The Provider | DEJONG |
| First Name Of The Provider | RICHARD |
| 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 | 15300 WEST AVENUE |
| Street Address 2 Of The Provider | SUITE 223 SOUTH |
| City Of The Provider | ORLAND PARK |
| Zip Code Of The Provider | 60462 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 5019 |
| Number Of Medicare Beneficiaries | 934 |
| Total Submitted Charge Amount | 451806 |
| Total Medicare Allowed Amount | 292704.63 |
| Total Medicare Payment Amount | 207552.2 |
| Total Medicare Standardized Payment Amount | 197715.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 429 |
| Number Of Medicare Beneficiaries With Drug Services | 305 |
| Total Drug Submitted ChargeAmount | 21601 |
| Total Drug Medicare AllowedAmount | 6087.51 |
| Total Drug Medicare PaymentAmount | 5744.68 |
| Total Drug Medicare Standardized Payment Amount | 5744.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 4590 |
| Number Of Medicare Beneficiaries With Medical Services | 934 |
| Total Medical Submitted Charge Amount | 430205 |
| Total Medical Medicare Allowed Amount | 286617.12 |
| Total Medical Medicare Payment Amount | 201807.52 |
| Total Medical Medicare Standardized Payment Amount | 191971.17 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 103 |
| Number Of Beneficiaries Age 65 to 74 | 339 |
| Number Of Beneficiaries Age 75 to 84 | 327 |
| Number Of Beneficiaries Age Greater 84 | 165 |
| Number Of Female Beneficiaries | 512 |
| Number Of Male Beneficiaries | 422 |
| Number Of Non Hispanic White Beneficiaries | 886 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 822 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 112 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0693 |