| National Provider Identifier [NPI]: | 1023217551 |
| Last Name Of The Provider | SHRISHRIMAL |
| First Name Of The Provider | KUMARPAL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 E PENNSYLVANIA AVE |
| Street Address 2 Of The Provider | SUITE 212 |
| City Of The Provider | PEORIA |
| Zip Code Of The Provider | 616033089 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 7092 |
| Number Of Medicare Beneficiaries | 863 |
| Total Submitted Charge Amount | 732379.48 |
| Total Medicare Allowed Amount | 378580.76 |
| Total Medicare Payment Amount | 283928.42 |
| Total Medicare Standardized Payment Amount | 291986.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 3783 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 15121.48 |
| Total Drug Medicare AllowedAmount | 10077.47 |
| Total Drug Medicare PaymentAmount | 7911.1 |
| Total Drug Medicare Standardized Payment Amount | 7911.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 3309 |
| Number Of Medicare Beneficiaries With Medical Services | 863 |
| Total Medical Submitted Charge Amount | 717258 |
| Total Medical Medicare Allowed Amount | 368503.29 |
| Total Medical Medicare Payment Amount | 276017.32 |
| Total Medical Medicare Standardized Payment Amount | 284075.72 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 181 |
| Number Of Beneficiaries Age 65 to 74 | 299 |
| Number Of Beneficiaries Age 75 to 84 | 237 |
| Number Of Beneficiaries Age Greater 84 | 146 |
| Number Of Female Beneficiaries | 477 |
| Number Of Male Beneficiaries | 386 |
| Number Of Non Hispanic White Beneficiaries | 758 |
| Number Of Black or African American Beneficiaries | 77 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 651 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 212 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 3.2096 |