| National Provider Identifier [NPI]: | 1922099084 |
| Last Name Of The Provider | SONG |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3000 N. HALSTED |
| Street Address 2 Of The Provider | SUITE 703 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 60657 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurosurgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 449 |
| Number Of Medicare Beneficiaries | 182 |
| Total Submitted Charge Amount | 731076 |
| Total Medicare Allowed Amount | 156502.56 |
| Total Medicare Payment Amount | 122147.91 |
| Total Medicare Standardized Payment Amount | 102733.87 |
| 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 | 57 |
| Number Of Medical Services | 449 |
| Number Of Medicare Beneficiaries With Medical Services | 182 |
| Total Medical Submitted Charge Amount | 731076 |
| Total Medical Medicare Allowed Amount | 156502.56 |
| Total Medical Medicare Payment Amount | 122147.91 |
| Total Medical Medicare Standardized Payment Amount | 102733.87 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 83 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 107 |
| Number Of Male Beneficiaries | 75 |
| Number Of Non Hispanic White Beneficiaries | 95 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 102 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 80 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 73 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.1808 |