| National Provider Identifier [NPI]: | 1548233117 |
| Last Name Of The Provider | ALI |
| First Name Of The Provider | SHEHZAD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4646 N MARINE DR |
| Street Address 2 Of The Provider | SUITE 6200C |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606405759 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 268 |
| Number Of Medicare Beneficiaries | 45 |
| Total Submitted Charge Amount | 30696 |
| Total Medicare Allowed Amount | 18800.93 |
| Total Medicare Payment Amount | 13865.24 |
| Total Medicare Standardized Payment Amount | 12961.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 15 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 765 |
| Total Drug Medicare AllowedAmount | 185.12 |
| Total Drug Medicare PaymentAmount | 181.44 |
| Total Drug Medicare Standardized Payment Amount | 181.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 253 |
| Number Of Medicare Beneficiaries With Medical Services | 45 |
| Total Medical Submitted Charge Amount | 29931 |
| Total Medical Medicare Allowed Amount | 18615.81 |
| Total Medical Medicare Payment Amount | 13683.8 |
| Total Medical Medicare Standardized Payment Amount | 12779.64 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 19 |
| Number Of Beneficiaries Age 75 to 84 | 15 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 20 |
| Number Of Male Beneficiaries | 25 |
| Number Of Non Hispanic White Beneficiaries | 15 |
| Number Of Black or African American Beneficiaries | 15 |
| 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 | 30 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1603 |