National Provider Identifier [NPI]: |
1568628485 |
Last Name Of The Provider |
BARAL |
First Name Of The Provider |
SHAILESH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
405 W JACKSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CARBONDALE |
Zip Code Of The Provider |
629011462 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
1110 |
Number Of Medicare Beneficiaries |
412 |
Total Submitted Charge Amount |
205496 |
Total Medicare Allowed Amount |
130078.14 |
Total Medicare Payment Amount |
99821.4 |
Total Medicare Standardized Payment Amount |
101113.16 |
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 |
15 |
Number Of Medical Services |
1110 |
Number Of Medicare Beneficiaries With Medical Services |
412 |
Total Medical Submitted Charge Amount |
205496 |
Total Medical Medicare Allowed Amount |
130078.14 |
Total Medical Medicare Payment Amount |
99821.4 |
Total Medical Medicare Standardized Payment Amount |
101113.16 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
90 |
Number Of Beneficiaries Age 65 to 74 |
131 |
Number Of Beneficiaries Age 75 to 84 |
133 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
211 |
Number Of Male Beneficiaries |
201 |
Number Of Non Hispanic White Beneficiaries |
372 |
Number Of Black or African American Beneficiaries |
|
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 |
247 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
165 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
50 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
74 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.3756 |