| National Provider Identifier [NPI]: | 1083616460 |
| Last Name Of The Provider | SHIEH |
| First Name Of The Provider | TED |
| Middle Initial Of The Provider | C |
| 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 | STE 230 |
| 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 | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 110 |
| Number Of Services | 3983 |
| Number Of Medicare Beneficiaries | 653 |
| Total Submitted Charge Amount | 365312 |
| Total Medicare Allowed Amount | 157809.28 |
| Total Medicare Payment Amount | 119265.88 |
| Total Medicare Standardized Payment Amount | 115427.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 30 |
| Number Of Drug Services | 2014 |
| Number Of Medicare Beneficiaries With Drug Services | 160 |
| Total Drug Submitted ChargeAmount | 107820 |
| Total Drug Medicare AllowedAmount | 43243.66 |
| Total Drug Medicare PaymentAmount | 33821.05 |
| Total Drug Medicare Standardized Payment Amount | 33821.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 1969 |
| Number Of Medicare Beneficiaries With Medical Services | 653 |
| Total Medical Submitted Charge Amount | 257492 |
| Total Medical Medicare Allowed Amount | 114565.62 |
| Total Medical Medicare Payment Amount | 85444.83 |
| Total Medical Medicare Standardized Payment Amount | 81606.83 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 316 |
| Number Of Beneficiaries Age 75 to 84 | 180 |
| Number Of Beneficiaries Age Greater 84 | 98 |
| Number Of Female Beneficiaries | 373 |
| Number Of Male Beneficiaries | 280 |
| Number Of Non Hispanic White Beneficiaries | 589 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 615 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0922 |