| National Provider Identifier [NPI]: | 1851354674 |
| Last Name Of The Provider | SHADUR |
| First Name Of The Provider | CRAIG |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1215 PLEASANT STREET |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | DES MOINES |
| Zip Code Of The Provider | 503091409 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 3025 |
| Number Of Medicare Beneficiaries | 715 |
| Total Submitted Charge Amount | 440661 |
| Total Medicare Allowed Amount | 219602.35 |
| Total Medicare Payment Amount | 165575.8 |
| Total Medicare Standardized Payment Amount | 166531.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 799 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 11307 |
| Total Drug Medicare AllowedAmount | 9201.88 |
| Total Drug Medicare PaymentAmount | 7045.56 |
| Total Drug Medicare Standardized Payment Amount | 7045.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 2226 |
| Number Of Medicare Beneficiaries With Medical Services | 715 |
| Total Medical Submitted Charge Amount | 429354 |
| Total Medical Medicare Allowed Amount | 210400.47 |
| Total Medical Medicare Payment Amount | 158530.24 |
| Total Medical Medicare Standardized Payment Amount | 159485.45 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 203 |
| Number Of Beneficiaries Age 65 to 74 | 256 |
| Number Of Beneficiaries Age 75 to 84 | 170 |
| Number Of Beneficiaries Age Greater 84 | 86 |
| Number Of Female Beneficiaries | 310 |
| Number Of Male Beneficiaries | 405 |
| Number Of Non Hispanic White Beneficiaries | 600 |
| Number Of Black or African American Beneficiaries | 61 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 517 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 198 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 3.6001 |