| National Provider Identifier [NPI]: | 1942248794 |
| Last Name Of The Provider | BRANDT |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7900 N MILWAUKEE AVE |
| Street Address 2 Of The Provider | SUITE 17 |
| City Of The Provider | NILES |
| Zip Code Of The Provider | 607143159 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 129 |
| Number Of Services | 18211 |
| Number Of Medicare Beneficiaries | 1942 |
| Total Submitted Charge Amount | 4198982 |
| Total Medicare Allowed Amount | 1143441.66 |
| Total Medicare Payment Amount | 859421.05 |
| Total Medicare Standardized Payment Amount | 818227.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 7215 |
| Number Of Medicare Beneficiaries With Drug Services | 88 |
| Total Drug Submitted ChargeAmount | 843132 |
| Total Drug Medicare AllowedAmount | 211100.74 |
| Total Drug Medicare PaymentAmount | 164973.36 |
| Total Drug Medicare Standardized Payment Amount | 164973.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 118 |
| Number Of Medical Services | 10996 |
| Number Of Medicare Beneficiaries With Medical Services | 1942 |
| Total Medical Submitted Charge Amount | 3355850 |
| Total Medical Medicare Allowed Amount | 932340.92 |
| Total Medical Medicare Payment Amount | 694447.69 |
| Total Medical Medicare Standardized Payment Amount | 653254.25 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 110 |
| Number Of Beneficiaries Age 65 to 74 | 691 |
| Number Of Beneficiaries Age 75 to 84 | 730 |
| Number Of Beneficiaries Age Greater 84 | 411 |
| Number Of Female Beneficiaries | 432 |
| Number Of Male Beneficiaries | 1510 |
| Number Of Non Hispanic White Beneficiaries | 1790 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 61 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1712 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 230 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 30 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3872 |