| National Provider Identifier [NPI]: | 1689632564 |
| Last Name Of The Provider | SCLAMBERG |
| First Name Of The Provider | JOY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1725 W HARRISON ST |
| Street Address 2 Of The Provider | SUITE 456 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606123841 |
| 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 | 68 |
| Number Of Services | 20114 |
| Number Of Medicare Beneficiaries | 3047 |
| Total Submitted Charge Amount | 1236155 |
| Total Medicare Allowed Amount | 220973.72 |
| Total Medicare Payment Amount | 170941.73 |
| Total Medicare Standardized Payment Amount | 165666.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 15050 |
| Number Of Medicare Beneficiaries With Drug Services | 122 |
| Total Drug Submitted ChargeAmount | 60200 |
| Total Drug Medicare AllowedAmount | 2705.58 |
| Total Drug Medicare PaymentAmount | 2109.79 |
| Total Drug Medicare Standardized Payment Amount | 2109.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 5064 |
| Number Of Medicare Beneficiaries With Medical Services | 3047 |
| Total Medical Submitted Charge Amount | 1175955 |
| Total Medical Medicare Allowed Amount | 218268.14 |
| Total Medical Medicare Payment Amount | 168831.94 |
| Total Medical Medicare Standardized Payment Amount | 163557.06 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 804 |
| Number Of Beneficiaries Age 65 to 74 | 1173 |
| Number Of Beneficiaries Age 75 to 84 | 761 |
| Number Of Beneficiaries Age Greater 84 | 309 |
| Number Of Female Beneficiaries | 1753 |
| Number Of Male Beneficiaries | 1294 |
| Number Of Non Hispanic White Beneficiaries | 1162 |
| Number Of Black or African American Beneficiaries | 1337 |
| Number Of AsianPacific Islander Beneficiaries | 54 |
| Number Of Hispanic Beneficiaries | 459 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1741 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1306 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 55 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.547 |