| National Provider Identifier [NPI]: | 1528052792 |
| Last Name Of The Provider | SHAFI |
| First Name Of The Provider | MOHAMMAD |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 812 CAMPUS DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | JOLIET |
| Zip Code Of The Provider | 604355128 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 71 |
| Number Of Services | 4917 |
| Number Of Medicare Beneficiaries | 606 |
| Total Submitted Charge Amount | 882067.54 |
| Total Medicare Allowed Amount | 403093.68 |
| Total Medicare Payment Amount | 308143.65 |
| Total Medicare Standardized Payment Amount | 296814.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 823 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 39698.39 |
| Total Drug Medicare AllowedAmount | 7667.79 |
| Total Drug Medicare PaymentAmount | 5985.2 |
| Total Drug Medicare Standardized Payment Amount | 5985.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 4094 |
| Number Of Medicare Beneficiaries With Medical Services | 606 |
| Total Medical Submitted Charge Amount | 842369.15 |
| Total Medical Medicare Allowed Amount | 395425.89 |
| Total Medical Medicare Payment Amount | 302158.45 |
| Total Medical Medicare Standardized Payment Amount | 290829.78 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 156 |
| Number Of Beneficiaries Age 65 to 74 | 163 |
| Number Of Beneficiaries Age 75 to 84 | 165 |
| Number Of Beneficiaries Age Greater 84 | 122 |
| Number Of Female Beneficiaries | 299 |
| Number Of Male Beneficiaries | 307 |
| Number Of Non Hispanic White Beneficiaries | 399 |
| Number Of Black or African American Beneficiaries | 130 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 60 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 360 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 246 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 63 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 68 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 4.3177 |