| National Provider Identifier [NPI]: | 1144241597 |
| Last Name Of The Provider | DALAL |
| First Name Of The Provider | SHAIL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3415 SOUTH LOOP 256 |
| Street Address 2 Of The Provider | |
| City Of The Provider | PALESTINE |
| Zip Code Of The Provider | 75801 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 120 |
| Number Of Services | 184548 |
| Number Of Medicare Beneficiaries | 527 |
| Total Submitted Charge Amount | 8447228 |
| Total Medicare Allowed Amount | 2364644.49 |
| Total Medicare Payment Amount | 1827739.88 |
| Total Medicare Standardized Payment Amount | 1846773.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 65 |
| Number Of Drug Services | 172768 |
| Number Of Medicare Beneficiaries With Drug Services | 189 |
| Total Drug Submitted ChargeAmount | 6469409 |
| Total Drug Medicare AllowedAmount | 1880517.52 |
| Total Drug Medicare PaymentAmount | 1451823.02 |
| Total Drug Medicare Standardized Payment Amount | 1451823.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 11780 |
| Number Of Medicare Beneficiaries With Medical Services | 526 |
| Total Medical Submitted Charge Amount | 1977819 |
| Total Medical Medicare Allowed Amount | 484126.97 |
| Total Medical Medicare Payment Amount | 375916.86 |
| Total Medical Medicare Standardized Payment Amount | 394950.39 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 185 |
| Number Of Beneficiaries Age 75 to 84 | 188 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 330 |
| Number Of Male Beneficiaries | 197 |
| Number Of Non Hispanic White Beneficiaries | 413 |
| Number Of Black or African American Beneficiaries | 94 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 384 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 143 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 39 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.8931 |