| National Provider Identifier [NPI]: | 1760477376 |
| Last Name Of The Provider | CHILDERS |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 MAPLE SUMMIT RD |
| Street Address 2 Of The Provider | STE 300 |
| City Of The Provider | JERSEYVILLE |
| Zip Code Of The Provider | 620522028 |
| 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 | 51 |
| Number Of Services | 2081 |
| Number Of Medicare Beneficiaries | 384 |
| Total Submitted Charge Amount | 276371 |
| Total Medicare Allowed Amount | 127808.51 |
| Total Medicare Payment Amount | 92397.37 |
| Total Medicare Standardized Payment Amount | 92649.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 117 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 57825 |
| Total Drug Medicare AllowedAmount | 23341.42 |
| Total Drug Medicare PaymentAmount | 18240.98 |
| Total Drug Medicare Standardized Payment Amount | 18240.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 1964 |
| Number Of Medicare Beneficiaries With Medical Services | 384 |
| Total Medical Submitted Charge Amount | 218546 |
| Total Medical Medicare Allowed Amount | 104467.09 |
| Total Medical Medicare Payment Amount | 74156.39 |
| Total Medical Medicare Standardized Payment Amount | 74408.61 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 138 |
| Number Of Beneficiaries Age 75 to 84 | 138 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 68 |
| Number Of Male Beneficiaries | 316 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 332 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0878 |