| National Provider Identifier [NPI]: | 1750336889 |
| Last Name Of The Provider | TRACY |
| First Name Of The Provider | PATRICK |
| 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 | 719 N WILLIAM KUMPF BLVD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | PEORIA |
| Zip Code Of The Provider | 61605 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurosurgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 755 |
| Number Of Medicare Beneficiaries | 309 |
| Total Submitted Charge Amount | 629981.03 |
| Total Medicare Allowed Amount | 165914.14 |
| Total Medicare Payment Amount | 127984.79 |
| Total Medicare Standardized Payment Amount | 129785.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 244 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 92335 |
| Total Drug Medicare AllowedAmount | 39897.8 |
| Total Drug Medicare PaymentAmount | 31204.54 |
| Total Drug Medicare Standardized Payment Amount | 31204.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 511 |
| Number Of Medicare Beneficiaries With Medical Services | 309 |
| Total Medical Submitted Charge Amount | 537646.03 |
| Total Medical Medicare Allowed Amount | 126016.34 |
| Total Medical Medicare Payment Amount | 96780.25 |
| Total Medical Medicare Standardized Payment Amount | 98581.14 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 112 |
| Number Of Beneficiaries Age 65 to 74 | 98 |
| Number Of Beneficiaries Age 75 to 84 | 67 |
| Number Of Beneficiaries Age Greater 84 | 32 |
| Number Of Female Beneficiaries | 148 |
| Number Of Male Beneficiaries | 161 |
| Number Of Non Hispanic White Beneficiaries | 286 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 210 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 99 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.5186 |