| National Provider Identifier [NPI]: | 1427052851 |
| Last Name Of The Provider | LEYENSON |
| First Name Of The Provider | VADIM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2800 N SHERIDAN RD |
| Street Address 2 Of The Provider | STE 301 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606576158 |
| 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 | 40 |
| Number Of Services | 3769 |
| Number Of Medicare Beneficiaries | 1172 |
| Total Submitted Charge Amount | 531322 |
| Total Medicare Allowed Amount | 396457.97 |
| Total Medicare Payment Amount | 300905.02 |
| Total Medicare Standardized Payment Amount | 282318.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 11 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 580 |
| Total Drug Medicare AllowedAmount | 459.92 |
| Total Drug Medicare PaymentAmount | 450.7 |
| Total Drug Medicare Standardized Payment Amount | 450.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 3758 |
| Number Of Medicare Beneficiaries With Medical Services | 1172 |
| Total Medical Submitted Charge Amount | 530742 |
| Total Medical Medicare Allowed Amount | 395998.05 |
| Total Medical Medicare Payment Amount | 300454.32 |
| Total Medical Medicare Standardized Payment Amount | 281867.65 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 100 |
| Number Of Beneficiaries Age 65 to 74 | 356 |
| Number Of Beneficiaries Age 75 to 84 | 434 |
| Number Of Beneficiaries Age Greater 84 | 282 |
| Number Of Female Beneficiaries | 642 |
| Number Of Male Beneficiaries | 530 |
| Number Of Non Hispanic White Beneficiaries | 971 |
| Number Of Black or African American Beneficiaries | 79 |
| Number Of AsianPacific Islander Beneficiaries | 54 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 697 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 475 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 23 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 48 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.3759 |