| National Provider Identifier [NPI]: | 1588616585 |
| Last Name Of The Provider | FENNER |
| First Name Of The Provider | PATRICK |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3825 HIGHLAND AVE |
| Street Address 2 Of The Provider | TOWER 2 SUITE 400 |
| City Of The Provider | DOWNERS GROVE |
| Zip Code Of The Provider | 605151552 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 4460 |
| Number Of Medicare Beneficiaries | 1567 |
| Total Submitted Charge Amount | 1222617.75 |
| Total Medicare Allowed Amount | 457169.25 |
| Total Medicare Payment Amount | 348886.39 |
| Total Medicare Standardized Payment Amount | 333726.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 475 |
| Number Of Medicare Beneficiaries With Drug Services | 121 |
| Total Drug Submitted ChargeAmount | 37539 |
| Total Drug Medicare AllowedAmount | 25078.85 |
| Total Drug Medicare PaymentAmount | 19519.22 |
| Total Drug Medicare Standardized Payment Amount | 19519.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 3985 |
| Number Of Medicare Beneficiaries With Medical Services | 1567 |
| Total Medical Submitted Charge Amount | 1185078.75 |
| Total Medical Medicare Allowed Amount | 432090.4 |
| Total Medical Medicare Payment Amount | 329367.17 |
| Total Medical Medicare Standardized Payment Amount | 314207.1 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 118 |
| Number Of Beneficiaries Age 65 to 74 | 576 |
| Number Of Beneficiaries Age 75 to 84 | 560 |
| Number Of Beneficiaries Age Greater 84 | 313 |
| Number Of Female Beneficiaries | 768 |
| Number Of Male Beneficiaries | 799 |
| Number Of Non Hispanic White Beneficiaries | 1407 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | 52 |
| Number Of Hispanic Beneficiaries | 58 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1363 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 204 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6445 |