| National Provider Identifier [NPI]: | 1194725523 |
| Last Name Of The Provider | GREENSPAN |
| First Name Of The Provider | JACOB |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 350 OAK KNOLL TER |
| Street Address 2 Of The Provider | |
| City Of The Provider | NORTHBROOK |
| Zip Code Of The Provider | 600621048 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 9001 |
| Number Of Medicare Beneficiaries | 1583 |
| Total Submitted Charge Amount | 770020 |
| Total Medicare Allowed Amount | 451609.12 |
| Total Medicare Payment Amount | 335426.53 |
| Total Medicare Standardized Payment Amount | 344855.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 9001 |
| Number Of Medicare Beneficiaries With Medical Services | 1583 |
| Total Medical Submitted Charge Amount | 770020 |
| Total Medical Medicare Allowed Amount | 451609.12 |
| Total Medical Medicare Payment Amount | 335426.53 |
| Total Medical Medicare Standardized Payment Amount | 344855.96 |
| Average Age Of Beneficiaries | 84 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 197 |
| Number Of Beneficiaries Age 75 to 84 | 463 |
| Number Of Beneficiaries Age Greater 84 | 885 |
| Number Of Female Beneficiaries | 1135 |
| Number Of Male Beneficiaries | 448 |
| Number Of Non Hispanic White Beneficiaries | 1521 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 905 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 678 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 66 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 20 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.0388 |