National Provider Identifier [NPI]: |
1801058409 |
Last Name Of The Provider |
ILAHI |
First Name Of The Provider |
SHAMS |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
BAYSTATE MEDICAL CENTER 759 CHESTNUT ST |
Street Address 2 Of The Provider |
S2570 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
011990001 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
1527 |
Number Of Medicare Beneficiaries |
465 |
Total Submitted Charge Amount |
258478 |
Total Medicare Allowed Amount |
137602.66 |
Total Medicare Payment Amount |
105682.81 |
Total Medicare Standardized Payment Amount |
107256.96 |
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 |
16 |
Number Of Medical Services |
1527 |
Number Of Medicare Beneficiaries With Medical Services |
465 |
Total Medical Submitted Charge Amount |
258478 |
Total Medical Medicare Allowed Amount |
137602.66 |
Total Medical Medicare Payment Amount |
105682.81 |
Total Medical Medicare Standardized Payment Amount |
107256.96 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
137 |
Number Of Beneficiaries Age Greater 84 |
127 |
Number Of Female Beneficiaries |
268 |
Number Of Male Beneficiaries |
197 |
Number Of Non Hispanic White Beneficiaries |
426 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
339 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
126 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.1448 |