| National Provider Identifier [NPI]: | 1770648073 |
| Last Name Of The Provider | SEIDES |
| First Name Of The Provider | BENJAMIN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD, MPH |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 BIESTERFIELD RD |
| Street Address 2 Of The Provider | STE 510 |
| City Of The Provider | ELK GROVE VILLAGE |
| Zip Code Of The Provider | 600073361 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 332 |
| Number Of Medicare Beneficiaries | 218 |
| Total Submitted Charge Amount | 88675 |
| Total Medicare Allowed Amount | 35830 |
| Total Medicare Payment Amount | 27935.7 |
| Total Medicare Standardized Payment Amount | 26452.92 |
| 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 | 21 |
| Number Of Medical Services | 332 |
| Number Of Medicare Beneficiaries With Medical Services | 218 |
| Total Medical Submitted Charge Amount | 88675 |
| Total Medical Medicare Allowed Amount | 35830 |
| Total Medical Medicare Payment Amount | 27935.7 |
| Total Medical Medicare Standardized Payment Amount | 26452.92 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 60 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 47 |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 95 |
| Number Of Non Hispanic White Beneficiaries | 186 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 166 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 43 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 23 |
| Percent Of With Cancer | 28 |
| Percent Of With Heart Failure | 57 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 66 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.2575 |