| National Provider Identifier [NPI]: | 1578557245 |
| Last Name Of The Provider | SHAMLOO |
| First Name Of The Provider | HOJJAT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2900 W 16TH STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEDFORD |
| Zip Code Of The Provider | 47421 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 4762 |
| Number Of Medicare Beneficiaries | 749 |
| Total Submitted Charge Amount | 387883.12 |
| Total Medicare Allowed Amount | 288457.09 |
| Total Medicare Payment Amount | 205045.51 |
| Total Medicare Standardized Payment Amount | 218882.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 571 |
| Number Of Medicare Beneficiaries With Drug Services | 233 |
| Total Drug Submitted ChargeAmount | 13935.34 |
| Total Drug Medicare AllowedAmount | 11003.95 |
| Total Drug Medicare PaymentAmount | 10348.67 |
| Total Drug Medicare Standardized Payment Amount | 10348.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 4191 |
| Number Of Medicare Beneficiaries With Medical Services | 749 |
| Total Medical Submitted Charge Amount | 373947.78 |
| Total Medical Medicare Allowed Amount | 277453.14 |
| Total Medical Medicare Payment Amount | 194696.84 |
| Total Medical Medicare Standardized Payment Amount | 208533.44 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 138 |
| Number Of Beneficiaries Age 65 to 74 | 293 |
| Number Of Beneficiaries Age 75 to 84 | 203 |
| Number Of Beneficiaries Age Greater 84 | 115 |
| Number Of Female Beneficiaries | 411 |
| Number Of Male Beneficiaries | 338 |
| Number Of Non Hispanic White Beneficiaries | 733 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 546 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 203 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3331 |