| National Provider Identifier [NPI]: | 1346440484 |
| Last Name Of The Provider | REID |
| First Name Of The Provider | GAIL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 840 SOUTH WOOD STREET |
| Street Address 2 Of The Provider | UNIVERSITY OF ILLINOIS, CHICAGO, DEPT OF MEDICINE |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 60612 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 405 |
| Number Of Medicare Beneficiaries | 212 |
| Total Submitted Charge Amount | 114133 |
| Total Medicare Allowed Amount | 43404.67 |
| Total Medicare Payment Amount | 33835.18 |
| Total Medicare Standardized Payment Amount | 31623.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 405 |
| Number Of Medicare Beneficiaries With Medical Services | 212 |
| Total Medical Submitted Charge Amount | 114133 |
| Total Medical Medicare Allowed Amount | 43404.67 |
| Total Medical Medicare Payment Amount | 33835.18 |
| Total Medical Medicare Standardized Payment Amount | 31623.64 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 79 |
| Number Of Beneficiaries Age 75 to 84 | 42 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 79 |
| Number Of Male Beneficiaries | 133 |
| Number Of Non Hispanic White Beneficiaries | 139 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 143 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 56 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 63 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 3.657 |