| National Provider Identifier [NPI]: | 1720222193 |
| Last Name Of The Provider | MORK |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1324 N SHERIDAN RD |
| Street Address 2 Of The Provider | VISTA MEDICAL CENTER |
| City Of The Provider | WAUKEGAN |
| Zip Code Of The Provider | 600852161 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 162 |
| Number Of Services | 4533 |
| Number Of Medicare Beneficiaries | 2642 |
| Total Submitted Charge Amount | 501466 |
| Total Medicare Allowed Amount | 155796.77 |
| Total Medicare Payment Amount | 119451.63 |
| Total Medicare Standardized Payment Amount | 115000.76 |
| 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 | 162 |
| Number Of Medical Services | 4533 |
| Number Of Medicare Beneficiaries With Medical Services | 2642 |
| Total Medical Submitted Charge Amount | 501466 |
| Total Medical Medicare Allowed Amount | 155796.77 |
| Total Medical Medicare Payment Amount | 119451.63 |
| Total Medical Medicare Standardized Payment Amount | 115000.76 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 614 |
| Number Of Beneficiaries Age 65 to 74 | 956 |
| Number Of Beneficiaries Age 75 to 84 | 714 |
| Number Of Beneficiaries Age Greater 84 | 358 |
| Number Of Female Beneficiaries | 1741 |
| Number Of Male Beneficiaries | 901 |
| Number Of Non Hispanic White Beneficiaries | 1604 |
| Number Of Black or African American Beneficiaries | 589 |
| Number Of AsianPacific Islander Beneficiaries | 63 |
| Number Of Hispanic Beneficiaries | 356 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1630 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1012 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6671 |