National Provider Identifier [NPI]: |
1972542611 |
Last Name Of The Provider |
SHAH |
First Name Of The Provider |
SHIRISH |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5600 W ADDISON ST |
Street Address 2 Of The Provider |
STE 400 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606344401 |
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 |
56 |
Number Of Services |
6893 |
Number Of Medicare Beneficiaries |
1910 |
Total Submitted Charge Amount |
1321002 |
Total Medicare Allowed Amount |
528060.88 |
Total Medicare Payment Amount |
401399.46 |
Total Medicare Standardized Payment Amount |
370988.27 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
49 |
Number Of Medicare Beneficiaries With Drug Services |
38 |
Total Drug Submitted ChargeAmount |
972 |
Total Drug Medicare AllowedAmount |
609.25 |
Total Drug Medicare PaymentAmount |
591.24 |
Total Drug Medicare Standardized Payment Amount |
591.24 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
51 |
Number Of Medical Services |
6844 |
Number Of Medicare Beneficiaries With Medical Services |
1910 |
Total Medical Submitted Charge Amount |
1320030 |
Total Medical Medicare Allowed Amount |
527451.63 |
Total Medical Medicare Payment Amount |
400808.22 |
Total Medical Medicare Standardized Payment Amount |
370397.03 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
249 |
Number Of Beneficiaries Age 65 to 74 |
539 |
Number Of Beneficiaries Age 75 to 84 |
608 |
Number Of Beneficiaries Age Greater 84 |
514 |
Number Of Female Beneficiaries |
1134 |
Number Of Male Beneficiaries |
776 |
Number Of Non Hispanic White Beneficiaries |
1273 |
Number Of Black or African American Beneficiaries |
99 |
Number Of AsianPacific Islander Beneficiaries |
52 |
Number Of Hispanic Beneficiaries |
461 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1040 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
870 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.1386 |