National Provider Identifier [NPI]: |
1770532699 |
Last Name Of The Provider |
SHABEEB |
First Name Of The Provider |
M |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10110 DONALD S POWERS |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
MUNSTER |
Zip Code Of The Provider |
463212915 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
110 |
Number Of Services |
1283 |
Number Of Medicare Beneficiaries |
439 |
Total Submitted Charge Amount |
947135 |
Total Medicare Allowed Amount |
307881.92 |
Total Medicare Payment Amount |
238834.47 |
Total Medicare Standardized Payment Amount |
244532.54 |
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 |
110 |
Number Of Medical Services |
1283 |
Number Of Medicare Beneficiaries With Medical Services |
439 |
Total Medical Submitted Charge Amount |
947135 |
Total Medical Medicare Allowed Amount |
307881.92 |
Total Medical Medicare Payment Amount |
238834.47 |
Total Medical Medicare Standardized Payment Amount |
244532.54 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
192 |
Number Of Beneficiaries Age 75 to 84 |
150 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
300 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
327 |
Number Of Black or African American Beneficiaries |
58 |
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 |
386 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
32 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.7336 |