| National Provider Identifier [NPI]: | 1134104144 |
| Last Name Of The Provider | NANDISH |
| First Name Of The Provider | SHAILESH |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 619 E MASON ST |
| Street Address 2 Of The Provider | SUITE 4P57 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 627011034 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 3367 |
| Number Of Medicare Beneficiaries | 1696 |
| Total Submitted Charge Amount | 1146646.11 |
| Total Medicare Allowed Amount | 241927.78 |
| Total Medicare Payment Amount | 184787.33 |
| Total Medicare Standardized Payment Amount | 182539.13 |
| 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 | 76 |
| Number Of Medical Services | 3367 |
| Number Of Medicare Beneficiaries With Medical Services | 1696 |
| Total Medical Submitted Charge Amount | 1146646.11 |
| Total Medical Medicare Allowed Amount | 241927.78 |
| Total Medical Medicare Payment Amount | 184787.33 |
| Total Medical Medicare Standardized Payment Amount | 182539.13 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 265 |
| Number Of Beneficiaries Age 65 to 74 | 565 |
| Number Of Beneficiaries Age 75 to 84 | 566 |
| Number Of Beneficiaries Age Greater 84 | 300 |
| Number Of Female Beneficiaries | 823 |
| Number Of Male Beneficiaries | 873 |
| Number Of Non Hispanic White Beneficiaries | 1613 |
| Number Of Black or African American Beneficiaries | 62 |
| 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 | 1241 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 455 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 44 |
| 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 | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6923 |