National Provider Identifier [NPI]: |
1235238973 |
Last Name Of The Provider |
SHAPIRO |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2454 E DEMPSTER ST |
Street Address 2 Of The Provider |
SUITE 400 |
City Of The Provider |
DES PLAINES |
Zip Code Of The Provider |
600165315 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
5112 |
Number Of Medicare Beneficiaries |
509 |
Total Submitted Charge Amount |
2104285.5 |
Total Medicare Allowed Amount |
1080204.39 |
Total Medicare Payment Amount |
834661.8 |
Total Medicare Standardized Payment Amount |
814607.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
1879 |
Number Of Medicare Beneficiaries With Drug Services |
149 |
Total Drug Submitted ChargeAmount |
1128949.5 |
Total Drug Medicare AllowedAmount |
735541.82 |
Total Drug Medicare PaymentAmount |
576663.1 |
Total Drug Medicare Standardized Payment Amount |
576663.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
3233 |
Number Of Medicare Beneficiaries With Medical Services |
509 |
Total Medical Submitted Charge Amount |
975336 |
Total Medical Medicare Allowed Amount |
344662.57 |
Total Medical Medicare Payment Amount |
257998.7 |
Total Medical Medicare Standardized Payment Amount |
237944.31 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
180 |
Number Of Beneficiaries Age 75 to 84 |
162 |
Number Of Beneficiaries Age Greater 84 |
115 |
Number Of Female Beneficiaries |
298 |
Number Of Male Beneficiaries |
211 |
Number Of Non Hispanic White Beneficiaries |
422 |
Number Of Black or African American Beneficiaries |
34 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
447 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4439 |