National Provider Identifier [NPI]: |
1598995995 |
Last Name Of The Provider |
SHAIKH |
First Name Of The Provider |
SUMAIRA |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
903 MINERAL POINT AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
JANESVILLE |
Zip Code Of The Provider |
535482970 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
110 |
Number Of Medicare Beneficiaries |
38 |
Total Submitted Charge Amount |
16936.69 |
Total Medicare Allowed Amount |
15662.22 |
Total Medicare Payment Amount |
12293.41 |
Total Medicare Standardized Payment Amount |
12680.44 |
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 |
18 |
Number Of Medical Services |
110 |
Number Of Medicare Beneficiaries With Medical Services |
38 |
Total Medical Submitted Charge Amount |
16936.69 |
Total Medical Medicare Allowed Amount |
15662.22 |
Total Medical Medicare Payment Amount |
12293.41 |
Total Medical Medicare Standardized Payment Amount |
12680.44 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
12 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
17 |
Number Of Male Beneficiaries |
21 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
25 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
|
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
5.648 |