| National Provider Identifier [NPI]: | 1376576793 |
| Last Name Of The Provider | DREYER |
| First Name Of The Provider | ROMAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4100 HEALTHWAY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | AURORA |
| Zip Code Of The Provider | 605044163 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 111 |
| Number Of Services | 3516 |
| Number Of Medicare Beneficiaries | 325 |
| Total Submitted Charge Amount | 348630 |
| Total Medicare Allowed Amount | 132986.3 |
| Total Medicare Payment Amount | 105856.34 |
| Total Medicare Standardized Payment Amount | 101573.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 107 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 3337 |
| Total Drug Medicare AllowedAmount | 1688.6 |
| Total Drug Medicare PaymentAmount | 1584.34 |
| Total Drug Medicare Standardized Payment Amount | 1584.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 3409 |
| Number Of Medicare Beneficiaries With Medical Services | 325 |
| Total Medical Submitted Charge Amount | 345293 |
| Total Medical Medicare Allowed Amount | 131297.7 |
| Total Medical Medicare Payment Amount | 104272 |
| Total Medical Medicare Standardized Payment Amount | 99989.14 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 155 |
| Number Of Beneficiaries Age 75 to 84 | 86 |
| Number Of Beneficiaries Age Greater 84 | 41 |
| Number Of Female Beneficiaries | 148 |
| Number Of Male Beneficiaries | 177 |
| Number Of Non Hispanic White Beneficiaries | 239 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 278 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3645 |