| National Provider Identifier [NPI]: | 1336137207 |
| Last Name Of The Provider | DERKEN |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 FOX GLEN DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BARRINGTON |
| Zip Code Of The Provider | 600101824 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 1406 |
| Number Of Medicare Beneficiaries | 311 |
| Total Submitted Charge Amount | 76167.97 |
| Total Medicare Allowed Amount | 71617.71 |
| Total Medicare Payment Amount | 57119.64 |
| Total Medicare Standardized Payment Amount | 55095.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 2512.14 |
| Total Drug Medicare AllowedAmount | 1816.64 |
| Total Drug Medicare PaymentAmount | 1779.58 |
| Total Drug Medicare Standardized Payment Amount | 1779.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 1382 |
| Number Of Medicare Beneficiaries With Medical Services | 311 |
| Total Medical Submitted Charge Amount | 73655.83 |
| Total Medical Medicare Allowed Amount | 69801.07 |
| Total Medical Medicare Payment Amount | 55340.06 |
| Total Medical Medicare Standardized Payment Amount | 53316.13 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 158 |
| Number Of Beneficiaries Age 75 to 84 | 98 |
| Number Of Beneficiaries Age Greater 84 | 42 |
| Number Of Female Beneficiaries | 247 |
| Number Of Male Beneficiaries | 64 |
| Number Of Non Hispanic White Beneficiaries | 300 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8414 |