National Provider Identifier [NPI]: |
1356508915 |
Last Name Of The Provider |
SHAH |
First Name Of The Provider |
NEEL |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
430 WARRENVILLE RD |
Street Address 2 Of The Provider |
300 |
City Of The Provider |
LISLE |
Zip Code Of The Provider |
60532 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
146 |
Number Of Services |
69468 |
Number Of Medicare Beneficiaries |
654 |
Total Submitted Charge Amount |
3031454.5 |
Total Medicare Allowed Amount |
1217599.92 |
Total Medicare Payment Amount |
945230.6 |
Total Medicare Standardized Payment Amount |
927424.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
75 |
Number Of Drug Services |
64138 |
Number Of Medicare Beneficiaries With Drug Services |
202 |
Total Drug Submitted ChargeAmount |
2401101.5 |
Total Drug Medicare AllowedAmount |
928293.48 |
Total Drug Medicare PaymentAmount |
720844.7 |
Total Drug Medicare Standardized Payment Amount |
720844.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
71 |
Number Of Medical Services |
5330 |
Number Of Medicare Beneficiaries With Medical Services |
651 |
Total Medical Submitted Charge Amount |
630353 |
Total Medical Medicare Allowed Amount |
289306.44 |
Total Medical Medicare Payment Amount |
224385.9 |
Total Medical Medicare Standardized Payment Amount |
206579.48 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
253 |
Number Of Beneficiaries Age 75 to 84 |
237 |
Number Of Beneficiaries Age Greater 84 |
93 |
Number Of Female Beneficiaries |
359 |
Number Of Male Beneficiaries |
295 |
Number Of Non Hispanic White Beneficiaries |
537 |
Number Of Black or African American Beneficiaries |
60 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
46 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
572 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
82 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
40 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.1705 |