| National Provider Identifier [NPI]: | 1477567394 |
| Last Name Of The Provider | SHADID |
| First Name Of The Provider | HYTHEM |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2900 FOXFIELD RD |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | ST CHARLES |
| Zip Code Of The Provider | 601745799 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 2826 |
| Number Of Medicare Beneficiaries | 212 |
| Total Submitted Charge Amount | 508549 |
| Total Medicare Allowed Amount | 143096.86 |
| Total Medicare Payment Amount | 108131 |
| Total Medicare Standardized Payment Amount | 101167.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2084 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 46599 |
| Total Drug Medicare AllowedAmount | 26270.7 |
| Total Drug Medicare PaymentAmount | 20424.53 |
| Total Drug Medicare Standardized Payment Amount | 20424.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 742 |
| Number Of Medicare Beneficiaries With Medical Services | 212 |
| Total Medical Submitted Charge Amount | 461950 |
| Total Medical Medicare Allowed Amount | 116826.16 |
| Total Medical Medicare Payment Amount | 87706.47 |
| Total Medical Medicare Standardized Payment Amount | 80742.99 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 108 |
| Number Of Beneficiaries Age 75 to 84 | 58 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 132 |
| Number Of Male Beneficiaries | 80 |
| Number Of Non Hispanic White Beneficiaries | 197 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 192 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 73 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8624 |