| National Provider Identifier [NPI]: | 1255355640 |
| Last Name Of The Provider | GREENSPAHN |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1875 DEMPSTER ST |
| Street Address 2 Of The Provider | SUITE 555 |
| City Of The Provider | PARK RIDGE |
| Zip Code Of The Provider | 600681186 |
| 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 | 77 |
| Number Of Services | 3098 |
| Number Of Medicare Beneficiaries | 762 |
| Total Submitted Charge Amount | 846898.2 |
| Total Medicare Allowed Amount | 340128.94 |
| Total Medicare Payment Amount | 258571.87 |
| Total Medicare Standardized Payment Amount | 242035.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 136 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 9998 |
| Total Drug Medicare AllowedAmount | 6731.21 |
| Total Drug Medicare PaymentAmount | 5296.54 |
| Total Drug Medicare Standardized Payment Amount | 5296.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 2962 |
| Number Of Medicare Beneficiaries With Medical Services | 762 |
| Total Medical Submitted Charge Amount | 836900.2 |
| Total Medical Medicare Allowed Amount | 333397.73 |
| Total Medical Medicare Payment Amount | 253275.33 |
| Total Medical Medicare Standardized Payment Amount | 236739.07 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 228 |
| Number Of Beneficiaries Age 75 to 84 | 295 |
| Number Of Beneficiaries Age Greater 84 | 207 |
| Number Of Female Beneficiaries | 322 |
| Number Of Male Beneficiaries | 440 |
| Number Of Non Hispanic White Beneficiaries | 708 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 678 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 84 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5364 |