| National Provider Identifier [NPI]: | 1144250838 |
| Last Name Of The Provider | RABY |
| First Name Of The Provider | THERI |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 N MICHIGAN AVE |
| Street Address 2 Of The Provider | SUITE 450 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606113777 |
| 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 | 30 |
| Number Of Services | 832 |
| Number Of Medicare Beneficiaries | 187 |
| Total Submitted Charge Amount | 118054 |
| Total Medicare Allowed Amount | 60774.45 |
| Total Medicare Payment Amount | 44755.52 |
| Total Medicare Standardized Payment Amount | 42270.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 114 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 960 |
| Total Drug Medicare AllowedAmount | 397.41 |
| Total Drug Medicare PaymentAmount | 328.13 |
| Total Drug Medicare Standardized Payment Amount | 328.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 718 |
| Number Of Medicare Beneficiaries With Medical Services | 187 |
| Total Medical Submitted Charge Amount | 117094 |
| Total Medical Medicare Allowed Amount | 60377.04 |
| Total Medical Medicare Payment Amount | 44427.39 |
| Total Medical Medicare Standardized Payment Amount | 41942.39 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 123 |
| Number Of Beneficiaries Age 75 to 84 | 40 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 146 |
| Number Of Male Beneficiaries | 41 |
| Number Of Non Hispanic White Beneficiaries | 139 |
| Number Of Black or African American Beneficiaries | 31 |
| 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 | 175 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 6 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 10 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 34 |
| Percent Of With Ischemic Heart Disease | 11 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7066 |