| National Provider Identifier [NPI]: | 1366433567 |
| Last Name Of The Provider | IRWIN |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2900 FRANK SCOTT PKWY W |
| Street Address 2 Of The Provider | SUITE 904 |
| City Of The Provider | BELLEVILLE |
| Zip Code Of The Provider | 622235000 |
| 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 | 45 |
| Number Of Services | 2002 |
| Number Of Medicare Beneficiaries | 308 |
| Total Submitted Charge Amount | 151106 |
| Total Medicare Allowed Amount | 100350.04 |
| Total Medicare Payment Amount | 69907.9 |
| Total Medicare Standardized Payment Amount | 68917.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 220 |
| Number Of Medicare Beneficiaries With Drug Services | 136 |
| Total Drug Submitted ChargeAmount | 7876 |
| Total Drug Medicare AllowedAmount | 4139.62 |
| Total Drug Medicare PaymentAmount | 3947.08 |
| Total Drug Medicare Standardized Payment Amount | 3947.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 1782 |
| Number Of Medicare Beneficiaries With Medical Services | 308 |
| Total Medical Submitted Charge Amount | 143230 |
| Total Medical Medicare Allowed Amount | 96210.42 |
| Total Medical Medicare Payment Amount | 65960.82 |
| Total Medical Medicare Standardized Payment Amount | 64970.41 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 96 |
| Number Of Beneficiaries Age 75 to 84 | 114 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 174 |
| Number Of Male Beneficiaries | 134 |
| Number Of Non Hispanic White Beneficiaries | 290 |
| 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 | 285 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2835 |