National Provider Identifier [NPI]: |
1821084773 |
Last Name Of The Provider |
SHAH |
First Name Of The Provider |
VIJAY |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1400 S LAKE PARK AVE |
Street Address 2 Of The Provider |
500 |
City Of The Provider |
HOBART |
Zip Code Of The Provider |
463426790 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
10069 |
Number Of Medicare Beneficiaries |
2566 |
Total Submitted Charge Amount |
2002300 |
Total Medicare Allowed Amount |
704640.87 |
Total Medicare Payment Amount |
541242.01 |
Total Medicare Standardized Payment Amount |
568502.12 |
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 |
41 |
Number Of Medical Services |
10069 |
Number Of Medicare Beneficiaries With Medical Services |
2566 |
Total Medical Submitted Charge Amount |
2002300 |
Total Medical Medicare Allowed Amount |
704640.87 |
Total Medical Medicare Payment Amount |
541242.01 |
Total Medical Medicare Standardized Payment Amount |
568502.12 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
589 |
Number Of Beneficiaries Age 65 to 74 |
820 |
Number Of Beneficiaries Age 75 to 84 |
711 |
Number Of Beneficiaries Age Greater 84 |
446 |
Number Of Female Beneficiaries |
1438 |
Number Of Male Beneficiaries |
1128 |
Number Of Non Hispanic White Beneficiaries |
1472 |
Number Of Black or African American Beneficiaries |
910 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
164 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1725 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
841 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.2844 |