| National Provider Identifier [NPI]: | 1740407634 |
| Last Name Of The Provider | NIKAM |
| First Name Of The Provider | SHIVPRASAD |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 E MOUNTAIN DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | WILKES BARRE |
| Zip Code Of The Provider | 187110027 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 123 |
| Number Of Services | 2012 |
| Number Of Medicare Beneficiaries | 1208 |
| Total Submitted Charge Amount | 2070445.5 |
| Total Medicare Allowed Amount | 197574.48 |
| Total Medicare Payment Amount | 150852.63 |
| Total Medicare Standardized Payment Amount | 150777.79 |
| 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 | 123 |
| Number Of Medical Services | 2012 |
| Number Of Medicare Beneficiaries With Medical Services | 1208 |
| Total Medical Submitted Charge Amount | 2070445.5 |
| Total Medical Medicare Allowed Amount | 197574.48 |
| Total Medical Medicare Payment Amount | 150852.63 |
| Total Medical Medicare Standardized Payment Amount | 150777.79 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 231 |
| Number Of Beneficiaries Age 65 to 74 | 421 |
| Number Of Beneficiaries Age 75 to 84 | 373 |
| Number Of Beneficiaries Age Greater 84 | 183 |
| Number Of Female Beneficiaries | 649 |
| Number Of Male Beneficiaries | 559 |
| Number Of Non Hispanic White Beneficiaries | 1151 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 894 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 314 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.0102 |