National Provider Identifier [NPI]: |
1730127275 |
Last Name Of The Provider |
SHADID |
First Name Of The Provider |
ANTHONY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 HIGHLAND AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537920001 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
238 |
Number Of Services |
6310 |
Number Of Medicare Beneficiaries |
3857 |
Total Submitted Charge Amount |
1259326 |
Total Medicare Allowed Amount |
208365.17 |
Total Medicare Payment Amount |
157160.04 |
Total Medicare Standardized Payment Amount |
160504.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
238 |
Number Of Medical Services |
6310 |
Number Of Medicare Beneficiaries With Medical Services |
3857 |
Total Medical Submitted Charge Amount |
1259326 |
Total Medical Medicare Allowed Amount |
208365.17 |
Total Medical Medicare Payment Amount |
157160.04 |
Total Medical Medicare Standardized Payment Amount |
160504.37 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
626 |
Number Of Beneficiaries Age 65 to 74 |
1335 |
Number Of Beneficiaries Age 75 to 84 |
1181 |
Number Of Beneficiaries Age Greater 84 |
715 |
Number Of Female Beneficiaries |
2211 |
Number Of Male Beneficiaries |
1646 |
Number Of Non Hispanic White Beneficiaries |
3593 |
Number Of Black or African American Beneficiaries |
195 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
42 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
2950 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
907 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6738 |