National Provider Identifier [NPI]: |
1679651103 |
Last Name Of The Provider |
SAYEED |
First Name Of The Provider |
SHAIK |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5900 S. LAKE DR. |
Street Address 2 Of The Provider |
LAKESHORE MEDICAL CLINIC |
City Of The Provider |
CUDAHY |
Zip Code Of The Provider |
531103171 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1841 |
Number Of Medicare Beneficiaries |
699 |
Total Submitted Charge Amount |
627728 |
Total Medicare Allowed Amount |
180374.4 |
Total Medicare Payment Amount |
132698.13 |
Total Medicare Standardized Payment Amount |
138017.25 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
36 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
252 |
Total Drug Medicare AllowedAmount |
65.63 |
Total Drug Medicare PaymentAmount |
45.6 |
Total Drug Medicare Standardized Payment Amount |
45.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
1805 |
Number Of Medicare Beneficiaries With Medical Services |
699 |
Total Medical Submitted Charge Amount |
627476 |
Total Medical Medicare Allowed Amount |
180308.77 |
Total Medical Medicare Payment Amount |
132652.53 |
Total Medical Medicare Standardized Payment Amount |
137971.65 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
148 |
Number Of Beneficiaries Age 65 to 74 |
191 |
Number Of Beneficiaries Age 75 to 84 |
223 |
Number Of Beneficiaries Age Greater 84 |
137 |
Number Of Female Beneficiaries |
421 |
Number Of Male Beneficiaries |
278 |
Number Of Non Hispanic White Beneficiaries |
566 |
Number Of Black or African American Beneficiaries |
78 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
34 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
445 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
254 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
39 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
26 |
Average HCC Risk Score Of Beneficiaries |
1.931 |