National Provider Identifier [NPI]: |
1194937789 |
Last Name Of The Provider |
SHAIKH |
First Name Of The Provider |
ARIF |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2650 RIDGE AVE |
Street Address 2 Of The Provider |
G 355 |
City Of The Provider |
EVANSTON |
Zip Code Of The Provider |
602011718 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
2748 |
Number Of Medicare Beneficiaries |
191 |
Total Submitted Charge Amount |
1010420 |
Total Medicare Allowed Amount |
290384.98 |
Total Medicare Payment Amount |
227402.93 |
Total Medicare Standardized Payment Amount |
204949.13 |
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 |
35 |
Number Of Medical Services |
2748 |
Number Of Medicare Beneficiaries With Medical Services |
191 |
Total Medical Submitted Charge Amount |
1010420 |
Total Medical Medicare Allowed Amount |
290384.98 |
Total Medical Medicare Payment Amount |
227402.93 |
Total Medical Medicare Standardized Payment Amount |
204949.13 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
76 |
Number Of Beneficiaries Age 75 to 84 |
73 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
79 |
Number Of Non Hispanic White Beneficiaries |
160 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
165 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
57 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6834 |