National Provider Identifier [NPI]: |
1023099306 |
Last Name Of The Provider |
SHALINI |
First Name Of The Provider |
KSHAMATA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3400 MINISTRY PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
WESTON |
Zip Code Of The Provider |
544765220 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
1361 |
Number Of Medicare Beneficiaries |
547 |
Total Submitted Charge Amount |
432361.91 |
Total Medicare Allowed Amount |
137009 |
Total Medicare Payment Amount |
106145.55 |
Total Medicare Standardized Payment Amount |
110722.09 |
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 |
28 |
Number Of Medical Services |
1361 |
Number Of Medicare Beneficiaries With Medical Services |
547 |
Total Medical Submitted Charge Amount |
432361.91 |
Total Medical Medicare Allowed Amount |
137009 |
Total Medical Medicare Payment Amount |
106145.55 |
Total Medical Medicare Standardized Payment Amount |
110722.09 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
107 |
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
180 |
Number Of Beneficiaries Age Greater 84 |
132 |
Number Of Female Beneficiaries |
316 |
Number Of Male Beneficiaries |
231 |
Number Of Non Hispanic White Beneficiaries |
498 |
Number Of Black or African American Beneficiaries |
17 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
371 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
176 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
64 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.2762 |