| National Provider Identifier [NPI]: | 1669449005 |
| Last Name Of The Provider | MICHL |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 SPALDING DR |
| Street Address 2 Of The Provider | STE 408 |
| City Of The Provider | NAPERVILLE |
| Zip Code Of The Provider | 605406550 |
| 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 | 86 |
| Number Of Services | 4324 |
| Number Of Medicare Beneficiaries | 540 |
| Total Submitted Charge Amount | 549226 |
| Total Medicare Allowed Amount | 261464.3 |
| Total Medicare Payment Amount | 202215.83 |
| Total Medicare Standardized Payment Amount | 193849.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 543 |
| Number Of Medicare Beneficiaries With Drug Services | 275 |
| Total Drug Submitted ChargeAmount | 50917 |
| Total Drug Medicare AllowedAmount | 30327.23 |
| Total Drug Medicare PaymentAmount | 29336.4 |
| Total Drug Medicare Standardized Payment Amount | 29336.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 3781 |
| Number Of Medicare Beneficiaries With Medical Services | 540 |
| Total Medical Submitted Charge Amount | 498309 |
| Total Medical Medicare Allowed Amount | 231137.07 |
| Total Medical Medicare Payment Amount | 172879.43 |
| Total Medical Medicare Standardized Payment Amount | 164512.99 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 308 |
| Number Of Beneficiaries Age 75 to 84 | 171 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 246 |
| Number Of Male Beneficiaries | 294 |
| Number Of Non Hispanic White Beneficiaries | 488 |
| Number Of Black or African American Beneficiaries | 21 |
| 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 | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9262 |