| National Provider Identifier [NPI]: | 1487619573 |
| Last Name Of The Provider | BRAASTAD |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1302 FRANKLIN AVE |
| Street Address 2 Of The Provider | SUITE 4500 |
| City Of The Provider | NORMAL |
| Zip Code Of The Provider | 617613551 |
| 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 | 84 |
| Number Of Services | 4244 |
| Number Of Medicare Beneficiaries | 1833 |
| Total Submitted Charge Amount | 835842 |
| Total Medicare Allowed Amount | 310132.49 |
| Total Medicare Payment Amount | 235989.54 |
| Total Medicare Standardized Payment Amount | 243109.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 210 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 16836 |
| Total Drug Medicare AllowedAmount | 11135.92 |
| Total Drug Medicare PaymentAmount | 8730.49 |
| Total Drug Medicare Standardized Payment Amount | 8730.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 4034 |
| Number Of Medicare Beneficiaries With Medical Services | 1833 |
| Total Medical Submitted Charge Amount | 819006 |
| Total Medical Medicare Allowed Amount | 298996.57 |
| Total Medical Medicare Payment Amount | 227259.05 |
| Total Medical Medicare Standardized Payment Amount | 234378.96 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 196 |
| Number Of Beneficiaries Age 65 to 74 | 644 |
| Number Of Beneficiaries Age 75 to 84 | 636 |
| Number Of Beneficiaries Age Greater 84 | 357 |
| Number Of Female Beneficiaries | 918 |
| Number Of Male Beneficiaries | 915 |
| Number Of Non Hispanic White Beneficiaries | 1737 |
| Number Of Black or African American Beneficiaries | 53 |
| 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 | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1559 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 274 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4238 |