National Provider Identifier [NPI]: |
1477668929 |
Last Name Of The Provider |
SHAH |
First Name Of The Provider |
PALMI |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1725 W HARRISON ST |
Street Address 2 Of The Provider |
SUITE 456 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606123841 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
33945 |
Number Of Medicare Beneficiaries |
3970 |
Total Submitted Charge Amount |
2511451 |
Total Medicare Allowed Amount |
373603.22 |
Total Medicare Payment Amount |
286774.99 |
Total Medicare Standardized Payment Amount |
276607.63 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
26540 |
Number Of Medicare Beneficiaries With Drug Services |
231 |
Total Drug Submitted ChargeAmount |
106160 |
Total Drug Medicare AllowedAmount |
5023.32 |
Total Drug Medicare PaymentAmount |
3887.97 |
Total Drug Medicare Standardized Payment Amount |
3887.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
7405 |
Number Of Medicare Beneficiaries With Medical Services |
3970 |
Total Medical Submitted Charge Amount |
2405291 |
Total Medical Medicare Allowed Amount |
368579.9 |
Total Medical Medicare Payment Amount |
282887.02 |
Total Medical Medicare Standardized Payment Amount |
272719.66 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
885 |
Number Of Beneficiaries Age 65 to 74 |
1572 |
Number Of Beneficiaries Age 75 to 84 |
1108 |
Number Of Beneficiaries Age Greater 84 |
405 |
Number Of Female Beneficiaries |
2282 |
Number Of Male Beneficiaries |
1688 |
Number Of Non Hispanic White Beneficiaries |
1750 |
Number Of Black or African American Beneficiaries |
1571 |
Number Of AsianPacific Islander Beneficiaries |
74 |
Number Of Hispanic Beneficiaries |
525 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
2390 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1580 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
26 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.3828 |