| National Provider Identifier [NPI]: | 1245375799 |
| Last Name Of The Provider | WORTMAN |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D, |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4940 S GREENWOOD AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606152816 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 130 |
| Number Of Services | 2241 |
| Number Of Medicare Beneficiaries | 1581 |
| Total Submitted Charge Amount | 372593 |
| Total Medicare Allowed Amount | 76097.47 |
| Total Medicare Payment Amount | 54304.77 |
| Total Medicare Standardized Payment Amount | 51395.78 |
| 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 | 130 |
| Number Of Medical Services | 2241 |
| Number Of Medicare Beneficiaries With Medical Services | 1581 |
| Total Medical Submitted Charge Amount | 372593 |
| Total Medical Medicare Allowed Amount | 76097.47 |
| Total Medical Medicare Payment Amount | 54304.77 |
| Total Medical Medicare Standardized Payment Amount | 51395.78 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 376 |
| Number Of Beneficiaries Age 65 to 74 | 571 |
| Number Of Beneficiaries Age 75 to 84 | 403 |
| Number Of Beneficiaries Age Greater 84 | 231 |
| Number Of Female Beneficiaries | 1014 |
| Number Of Male Beneficiaries | 567 |
| Number Of Non Hispanic White Beneficiaries | 510 |
| Number Of Black or African American Beneficiaries | 925 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 115 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 860 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 721 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.0364 |