National Provider Identifier [NPI]: |
1770570178 |
Last Name Of The Provider |
SHAH |
First Name Of The Provider |
SYED |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8460 US HIGHWAY 42 |
Street Address 2 Of The Provider |
|
City Of The Provider |
FLORENCE |
Zip Code Of The Provider |
410429642 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
659 |
Number Of Medicare Beneficiaries |
447 |
Total Submitted Charge Amount |
400701.29 |
Total Medicare Allowed Amount |
70227.59 |
Total Medicare Payment Amount |
52621.55 |
Total Medicare Standardized Payment Amount |
54734.89 |
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 |
34 |
Number Of Medical Services |
659 |
Number Of Medicare Beneficiaries With Medical Services |
447 |
Total Medical Submitted Charge Amount |
400701.29 |
Total Medical Medicare Allowed Amount |
70227.59 |
Total Medical Medicare Payment Amount |
52621.55 |
Total Medical Medicare Standardized Payment Amount |
54734.89 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
206 |
Number Of Beneficiaries Age 65 to 74 |
136 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
223 |
Number Of Male Beneficiaries |
224 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
175 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
272 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
49 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6722 |