| National Provider Identifier [NPI]: | 1376663526 |
| Last Name Of The Provider | SHIDAL |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 NO. 16TH ST. |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW CASTLE |
| Zip Code Of The Provider | 473624319 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 156 |
| Number Of Services | 5501 |
| Number Of Medicare Beneficiaries | 2470 |
| Total Submitted Charge Amount | 684897 |
| Total Medicare Allowed Amount | 144717.49 |
| Total Medicare Payment Amount | 110269.48 |
| Total Medicare Standardized Payment Amount | 116665.59 |
| 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 | 156 |
| Number Of Medical Services | 5501 |
| Number Of Medicare Beneficiaries With Medical Services | 2470 |
| Total Medical Submitted Charge Amount | 684897 |
| Total Medical Medicare Allowed Amount | 144717.49 |
| Total Medical Medicare Payment Amount | 110269.48 |
| Total Medical Medicare Standardized Payment Amount | 116665.59 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 526 |
| Number Of Beneficiaries Age 65 to 74 | 864 |
| Number Of Beneficiaries Age 75 to 84 | 677 |
| Number Of Beneficiaries Age Greater 84 | 403 |
| Number Of Female Beneficiaries | 1624 |
| Number Of Male Beneficiaries | 846 |
| Number Of Non Hispanic White Beneficiaries | 2407 |
| Number Of Black or African American Beneficiaries | 37 |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1778 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 692 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2916 |