| National Provider Identifier [NPI]: | 1598872160 |
| Last Name Of The Provider | MICHAEL |
| First Name Of The Provider | JOHN |
| 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 | 820 E TERRA COTTA AVE STE 247 |
| Street Address 2 Of The Provider | |
| City Of The Provider | CRYSTAL LAKE |
| Zip Code Of The Provider | 600143655 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 16140 |
| Number Of Medicare Beneficiaries | 1507 |
| Total Submitted Charge Amount | 6726150 |
| Total Medicare Allowed Amount | 2280000.89 |
| Total Medicare Payment Amount | 1736477.08 |
| Total Medicare Standardized Payment Amount | 1687606.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 4187 |
| Number Of Medicare Beneficiaries With Drug Services | 378 |
| Total Drug Submitted ChargeAmount | 3247600 |
| Total Drug Medicare AllowedAmount | 1112265.91 |
| Total Drug Medicare PaymentAmount | 863554.48 |
| Total Drug Medicare Standardized Payment Amount | 863554.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 11953 |
| Number Of Medicare Beneficiaries With Medical Services | 1507 |
| Total Medical Submitted Charge Amount | 3478550 |
| Total Medical Medicare Allowed Amount | 1167734.98 |
| Total Medical Medicare Payment Amount | 872922.6 |
| Total Medical Medicare Standardized Payment Amount | 824051.73 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 110 |
| Number Of Beneficiaries Age 65 to 74 | 583 |
| Number Of Beneficiaries Age 75 to 84 | 532 |
| Number Of Beneficiaries Age Greater 84 | 282 |
| Number Of Female Beneficiaries | 883 |
| Number Of Male Beneficiaries | 624 |
| Number Of Non Hispanic White Beneficiaries | 1269 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | 117 |
| Number Of Hispanic Beneficiaries | 59 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 50 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1165 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 342 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4031 |