| National Provider Identifier [NPI]: | 1043303803 |
| Last Name Of The Provider | FAHRENBACH |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7447 TALCOTT |
| Street Address 2 Of The Provider | SUITE 209 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606313713 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 19542 |
| Number Of Medicare Beneficiaries | 259 |
| Total Submitted Charge Amount | 1490787.5 |
| Total Medicare Allowed Amount | 1030062.88 |
| Total Medicare Payment Amount | 800995.72 |
| Total Medicare Standardized Payment Amount | 792568.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 17965 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 1255287.5 |
| Total Drug Medicare AllowedAmount | 896216.48 |
| Total Drug Medicare PaymentAmount | 702323.5 |
| Total Drug Medicare Standardized Payment Amount | 702323.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 1577 |
| Number Of Medicare Beneficiaries With Medical Services | 259 |
| Total Medical Submitted Charge Amount | 235500 |
| Total Medical Medicare Allowed Amount | 133846.4 |
| Total Medical Medicare Payment Amount | 98672.22 |
| Total Medical Medicare Standardized Payment Amount | 90245.11 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 80 |
| Number Of Beneficiaries Age 75 to 84 | 94 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 188 |
| Number Of Male Beneficiaries | 71 |
| Number Of Non Hispanic White Beneficiaries | 239 |
| Number Of Black or African American Beneficiaries | |
| 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 | 231 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2708 |