| National Provider Identifier [NPI]: | 1710947601 |
| Last Name Of The Provider | SCHLENTZ |
| First Name Of The Provider | MARIE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1340 S DAMEN AVE |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606081169 |
| 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 | 9 |
| Number Of Services | 541 |
| Number Of Medicare Beneficiaries | 177 |
| Total Submitted Charge Amount | 70156.55 |
| Total Medicare Allowed Amount | 55503.8 |
| Total Medicare Payment Amount | 43893.46 |
| Total Medicare Standardized Payment Amount | 43797.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 46 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 926.48 |
| Total Drug Medicare AllowedAmount | 741.03 |
| Total Drug Medicare PaymentAmount | 726.26 |
| Total Drug Medicare Standardized Payment Amount | 726.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 7 |
| Number Of Medical Services | 495 |
| Number Of Medicare Beneficiaries With Medical Services | 176 |
| Total Medical Submitted Charge Amount | 69230.07 |
| Total Medical Medicare Allowed Amount | 54762.77 |
| Total Medical Medicare Payment Amount | 43167.2 |
| Total Medical Medicare Standardized Payment Amount | 43071.47 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 39 |
| Number Of Beneficiaries Age 75 to 84 | 54 |
| Number Of Beneficiaries Age Greater 84 | 61 |
| Number Of Female Beneficiaries | 127 |
| Number Of Male Beneficiaries | 50 |
| Number Of Non Hispanic White Beneficiaries | 81 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 55 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 78 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 99 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 46 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.1163 |