National Provider Identifier [NPI]: |
1205855111 |
Last Name Of The Provider |
SHAH |
First Name Of The Provider |
UMEDCHANDRA |
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 |
26840 POINT LOOKOUT RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LEONARDTOWN |
Zip Code Of The Provider |
20650 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
2654 |
Number Of Medicare Beneficiaries |
853 |
Total Submitted Charge Amount |
763172 |
Total Medicare Allowed Amount |
264307.32 |
Total Medicare Payment Amount |
199489.4 |
Total Medicare Standardized Payment Amount |
197849.23 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
441 |
Number Of Beneficiaries Age 75 to 84 |
204 |
Number Of Beneficiaries Age Greater 84 |
81 |
Number Of Female Beneficiaries |
469 |
Number Of Male Beneficiaries |
384 |
Number Of Non Hispanic White Beneficiaries |
675 |
Number Of Black or African American Beneficiaries |
139 |
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 |
20 |
Number Of Beneficiaries With Medicare Only Entitlement |
681 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
172 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4373 |