| National Provider Identifier [NPI]: | 1740254473 |
| Last Name Of The Provider | SHTIVELBAND |
| First Name Of The Provider | MIKHAIL |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 695 S DOBSON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHANDLER |
| Zip Code Of The Provider | 852245665 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 115 |
| Number Of Services | 170494 |
| Number Of Medicare Beneficiaries | 559 |
| Total Submitted Charge Amount | 4481928 |
| Total Medicare Allowed Amount | 2320252.02 |
| Total Medicare Payment Amount | 1793777.13 |
| Total Medicare Standardized Payment Amount | 1799656.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 67 |
| Number Of Drug Services | 165131 |
| Number Of Medicare Beneficiaries With Drug Services | 227 |
| Total Drug Submitted ChargeAmount | 3481857 |
| Total Drug Medicare AllowedAmount | 1802763.23 |
| Total Drug Medicare PaymentAmount | 1401856.09 |
| Total Drug Medicare Standardized Payment Amount | 1401856.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 5363 |
| Number Of Medicare Beneficiaries With Medical Services | 559 |
| Total Medical Submitted Charge Amount | 1000071 |
| Total Medical Medicare Allowed Amount | 517488.79 |
| Total Medical Medicare Payment Amount | 391921.04 |
| Total Medical Medicare Standardized Payment Amount | 397800.28 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 68 |
| Number Of Beneficiaries Age 65 to 74 | 266 |
| Number Of Beneficiaries Age 75 to 84 | 160 |
| Number Of Beneficiaries Age Greater 84 | 65 |
| Number Of Female Beneficiaries | 313 |
| Number Of Male Beneficiaries | 246 |
| Number Of Non Hispanic White Beneficiaries | 466 |
| Number Of Black or African American Beneficiaries | 25 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | 14 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 501 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 42 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.927 |