| National Provider Identifier [NPI]: | 1912925090 |
| Last Name Of The Provider | SPORN |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 675 N SAINT CLAIR ST |
| Street Address 2 Of The Provider | SUITE 18-250 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606115975 |
| 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 | 36 |
| Number Of Services | 701 |
| Number Of Medicare Beneficiaries | 239 |
| Total Submitted Charge Amount | 232207 |
| Total Medicare Allowed Amount | 72485.15 |
| Total Medicare Payment Amount | 55028.93 |
| Total Medicare Standardized Payment Amount | 52383.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 16 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 2130 |
| Total Drug Medicare AllowedAmount | 960.13 |
| Total Drug Medicare PaymentAmount | 940.91 |
| Total Drug Medicare Standardized Payment Amount | 940.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 685 |
| Number Of Medicare Beneficiaries With Medical Services | 239 |
| Total Medical Submitted Charge Amount | 230077 |
| Total Medical Medicare Allowed Amount | 71525.02 |
| Total Medical Medicare Payment Amount | 54088.02 |
| Total Medical Medicare Standardized Payment Amount | 51442.97 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 104 |
| Number Of Beneficiaries Age 75 to 84 | 62 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 133 |
| Number Of Male Beneficiaries | 106 |
| Number Of Non Hispanic White Beneficiaries | 152 |
| Number Of Black or African American Beneficiaries | 69 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 191 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 24 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 49 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.1437 |