| National Provider Identifier [NPI]: | 1740236835 |
| Last Name Of The Provider | SHANES |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 675 W NORTH AVE |
| Street Address 2 Of The Provider | SUITE-210 |
| City Of The Provider | MELROSE PARK |
| Zip Code Of The Provider | 601601634 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 5226 |
| Number Of Medicare Beneficiaries | 2140 |
| Total Submitted Charge Amount | 927923 |
| Total Medicare Allowed Amount | 320322.16 |
| Total Medicare Payment Amount | 239293.01 |
| Total Medicare Standardized Payment Amount | 229088.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 121 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 12062 |
| Total Drug Medicare AllowedAmount | 6192.38 |
| Total Drug Medicare PaymentAmount | 4856.08 |
| Total Drug Medicare Standardized Payment Amount | 4856.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 5105 |
| Number Of Medicare Beneficiaries With Medical Services | 2140 |
| Total Medical Submitted Charge Amount | 915861 |
| Total Medical Medicare Allowed Amount | 314129.78 |
| Total Medical Medicare Payment Amount | 234436.93 |
| Total Medical Medicare Standardized Payment Amount | 224232.79 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 223 |
| Number Of Beneficiaries Age 65 to 74 | 677 |
| Number Of Beneficiaries Age 75 to 84 | 700 |
| Number Of Beneficiaries Age Greater 84 | 540 |
| Number Of Female Beneficiaries | 1218 |
| Number Of Male Beneficiaries | 922 |
| Number Of Non Hispanic White Beneficiaries | 1547 |
| Number Of Black or African American Beneficiaries | 226 |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 296 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1654 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 486 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9102 |