| National Provider Identifier [NPI]: | 1609844927 |
| Last Name Of The Provider | SCHABERG |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2601 W MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CARBONDALE |
| Zip Code Of The Provider | 629011031 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 4704 |
| Number Of Medicare Beneficiaries | 750 |
| Total Submitted Charge Amount | 472161.64 |
| Total Medicare Allowed Amount | 279383.07 |
| Total Medicare Payment Amount | 199459.05 |
| Total Medicare Standardized Payment Amount | 197508.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 65 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 17101 |
| Total Drug Medicare AllowedAmount | 15299.94 |
| Total Drug Medicare PaymentAmount | 11939.35 |
| Total Drug Medicare Standardized Payment Amount | 11939.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 4639 |
| Number Of Medicare Beneficiaries With Medical Services | 750 |
| Total Medical Submitted Charge Amount | 455060.64 |
| Total Medical Medicare Allowed Amount | 264083.13 |
| Total Medical Medicare Payment Amount | 187519.7 |
| Total Medical Medicare Standardized Payment Amount | 185569.18 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 366 |
| Number Of Beneficiaries Age 75 to 84 | 233 |
| Number Of Beneficiaries Age Greater 84 | 95 |
| Number Of Female Beneficiaries | 420 |
| Number Of Male Beneficiaries | 330 |
| Number Of Non Hispanic White Beneficiaries | 731 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 701 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9692 |