National Provider Identifier [NPI]: |
1356668677 |
Last Name Of The Provider |
SHAH |
First Name Of The Provider |
SALONI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5171 S COTTONWOOD ST |
Street Address 2 Of The Provider |
STE 740 |
City Of The Provider |
MURRAY |
Zip Code Of The Provider |
841075704 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
223 |
Number Of Medicare Beneficiaries |
129 |
Total Submitted Charge Amount |
85485.94 |
Total Medicare Allowed Amount |
18787.62 |
Total Medicare Payment Amount |
14392.52 |
Total Medicare Standardized Payment Amount |
14881.66 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
223 |
Number Of Medicare Beneficiaries With Medical Services |
129 |
Total Medical Submitted Charge Amount |
85485.94 |
Total Medical Medicare Allowed Amount |
18787.62 |
Total Medical Medicare Payment Amount |
14392.52 |
Total Medical Medicare Standardized Payment Amount |
14881.66 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
76 |
Number Of Male Beneficiaries |
53 |
Number Of Non Hispanic White Beneficiaries |
115 |
Number Of Black or African American Beneficiaries |
|
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
83 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.5545 |