| National Provider Identifier [NPI]: | 1043313356 |
| Last Name Of The Provider | ZUCKERMAN |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 FODEN ROAD |
| Street Address 2 Of The Provider | WEST BUILDING SUITE 103 |
| City Of The Provider | SOUTH PORTLAND |
| Zip Code Of The Provider | 04106 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 1895 |
| Number Of Medicare Beneficiaries | 549 |
| Total Submitted Charge Amount | 307819 |
| Total Medicare Allowed Amount | 151824.68 |
| Total Medicare Payment Amount | 113106.03 |
| Total Medicare Standardized Payment Amount | 113298.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 1059 |
| Total Drug Medicare AllowedAmount | 536.4 |
| Total Drug Medicare PaymentAmount | 525.72 |
| Total Drug Medicare Standardized Payment Amount | 525.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 1866 |
| Number Of Medicare Beneficiaries With Medical Services | 549 |
| Total Medical Submitted Charge Amount | 306760 |
| Total Medical Medicare Allowed Amount | 151288.28 |
| Total Medical Medicare Payment Amount | 112580.31 |
| Total Medical Medicare Standardized Payment Amount | 112772.47 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 143 |
| Number Of Beneficiaries Age 65 to 74 | 190 |
| Number Of Beneficiaries Age 75 to 84 | 160 |
| Number Of Beneficiaries Age Greater 84 | 56 |
| Number Of Female Beneficiaries | 293 |
| Number Of Male Beneficiaries | 256 |
| Number Of Non Hispanic White Beneficiaries | 526 |
| Number Of Black or African American Beneficiaries | |
| 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 | 332 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 217 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 47 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 2.0289 |