| National Provider Identifier [NPI]: | 1932107778 |
| Last Name Of The Provider | MACK |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. P C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1220 W HIGGINS RD |
| Street Address 2 Of The Provider | STE 102 |
| City Of The Provider | HOFFMAN ESTATES |
| Zip Code Of The Provider | 601694033 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 4643 |
| Number Of Medicare Beneficiaries | 990 |
| Total Submitted Charge Amount | 1642423 |
| Total Medicare Allowed Amount | 816283.69 |
| Total Medicare Payment Amount | 605879.95 |
| Total Medicare Standardized Payment Amount | 578119.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 143 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 720 |
| Total Drug Medicare AllowedAmount | 256.42 |
| Total Drug Medicare PaymentAmount | 201 |
| Total Drug Medicare Standardized Payment Amount | 201 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 4500 |
| Number Of Medicare Beneficiaries With Medical Services | 990 |
| Total Medical Submitted Charge Amount | 1641703 |
| Total Medical Medicare Allowed Amount | 816027.27 |
| Total Medical Medicare Payment Amount | 605678.95 |
| Total Medical Medicare Standardized Payment Amount | 577918.76 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 537 |
| Number Of Beneficiaries Age 75 to 84 | 267 |
| Number Of Beneficiaries Age Greater 84 | 123 |
| Number Of Female Beneficiaries | 571 |
| Number Of Male Beneficiaries | 419 |
| Number Of Non Hispanic White Beneficiaries | 812 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | 53 |
| Number Of Hispanic Beneficiaries | 86 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 878 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 112 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0871 |