| National Provider Identifier [NPI]: | 1619944675 |
| Last Name Of The Provider | PORCELLI |
| First Name Of The Provider | JOHN |
| 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 | 3825 HIGHLAND AVE |
| Street Address 2 Of The Provider | TWR II STE 310 |
| City Of The Provider | DOWNERS GROVE |
| Zip Code Of The Provider | 605151552 |
| 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 | 50 |
| Number Of Services | 3521 |
| Number Of Medicare Beneficiaries | 1345 |
| Total Submitted Charge Amount | 1346382 |
| Total Medicare Allowed Amount | 544229.01 |
| Total Medicare Payment Amount | 414599.34 |
| Total Medicare Standardized Payment Amount | 393701.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 57 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 3899 |
| Total Drug Medicare AllowedAmount | 2357.89 |
| Total Drug Medicare PaymentAmount | 2310.68 |
| Total Drug Medicare Standardized Payment Amount | 2310.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 3464 |
| Number Of Medicare Beneficiaries With Medical Services | 1345 |
| Total Medical Submitted Charge Amount | 1342483 |
| Total Medical Medicare Allowed Amount | 541871.12 |
| Total Medical Medicare Payment Amount | 412288.66 |
| Total Medical Medicare Standardized Payment Amount | 391390.66 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 106 |
| Number Of Beneficiaries Age 65 to 74 | 560 |
| Number Of Beneficiaries Age 75 to 84 | 456 |
| Number Of Beneficiaries Age Greater 84 | 223 |
| Number Of Female Beneficiaries | 675 |
| Number Of Male Beneficiaries | 670 |
| Number Of Non Hispanic White Beneficiaries | 1211 |
| Number Of Black or African American Beneficiaries | 34 |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1213 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 132 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6141 |