| National Provider Identifier [NPI]: | 1184673519 |
| Last Name Of The Provider | SHIN |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 840 W IRVING PARK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606133011 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 1904 |
| Number Of Medicare Beneficiaries | 327 |
| Total Submitted Charge Amount | 281371.93 |
| Total Medicare Allowed Amount | 155901.67 |
| Total Medicare Payment Amount | 112226.63 |
| Total Medicare Standardized Payment Amount | 106382.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 79 |
| Number Of Medicare Beneficiaries With Drug Services | 74 |
| Total Drug Submitted ChargeAmount | 5157.27 |
| Total Drug Medicare AllowedAmount | 2213.73 |
| Total Drug Medicare PaymentAmount | 2164.02 |
| Total Drug Medicare Standardized Payment Amount | 2164.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 1825 |
| Number Of Medicare Beneficiaries With Medical Services | 327 |
| Total Medical Submitted Charge Amount | 276214.66 |
| Total Medical Medicare Allowed Amount | 153687.94 |
| Total Medical Medicare Payment Amount | 110062.61 |
| Total Medical Medicare Standardized Payment Amount | 104218.86 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 89 |
| Number Of Beneficiaries Age 75 to 84 | 119 |
| Number Of Beneficiaries Age Greater 84 | 93 |
| Number Of Female Beneficiaries | 215 |
| Number Of Male Beneficiaries | 112 |
| Number Of Non Hispanic White Beneficiaries | 52 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | 230 |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 60 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 267 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 37 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 29 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.581 |