| National Provider Identifier [NPI]: | 1316060965 |
| Last Name Of The Provider | DAS |
| First Name Of The Provider | SHANKAR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8700 S DANTE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606197118 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 1031 |
| Number Of Medicare Beneficiaries | 166 |
| Total Submitted Charge Amount | 121409 |
| Total Medicare Allowed Amount | 76702.32 |
| Total Medicare Payment Amount | 57518.5 |
| Total Medicare Standardized Payment Amount | 54092.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 107 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 3161 |
| Total Drug Medicare AllowedAmount | 144.7 |
| Total Drug Medicare PaymentAmount | 126.97 |
| Total Drug Medicare Standardized Payment Amount | 126.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 924 |
| Number Of Medicare Beneficiaries With Medical Services | 166 |
| Total Medical Submitted Charge Amount | 118248 |
| Total Medical Medicare Allowed Amount | 76557.62 |
| Total Medical Medicare Payment Amount | 57391.53 |
| Total Medical Medicare Standardized Payment Amount | 53965.72 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 65 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 109 |
| Number Of Male Beneficiaries | 57 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 128 |
| 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 | 55 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 111 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1499 |