| National Provider Identifier [NPI]: | 1811156391 |
| Last Name Of The Provider | ALI |
| First Name Of The Provider | SHAHID |
| 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 | 3929 MERCY DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MCHENRY |
| Zip Code Of The Provider | 600503151 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 194 |
| Number Of Services | 5088 |
| Number Of Medicare Beneficiaries | 3322 |
| Total Submitted Charge Amount | 1009897 |
| Total Medicare Allowed Amount | 197194.01 |
| Total Medicare Payment Amount | 153763.56 |
| Total Medicare Standardized Payment Amount | 158680.73 |
| 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 | 194 |
| Number Of Medical Services | 5088 |
| Number Of Medicare Beneficiaries With Medical Services | 3322 |
| Total Medical Submitted Charge Amount | 1009897 |
| Total Medical Medicare Allowed Amount | 197194.01 |
| Total Medical Medicare Payment Amount | 153763.56 |
| Total Medical Medicare Standardized Payment Amount | 158680.73 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 467 |
| Number Of Beneficiaries Age 65 to 74 | 1329 |
| Number Of Beneficiaries Age 75 to 84 | 967 |
| Number Of Beneficiaries Age Greater 84 | 559 |
| Number Of Female Beneficiaries | 1964 |
| Number Of Male Beneficiaries | 1358 |
| Number Of Non Hispanic White Beneficiaries | 3168 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | 75 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2758 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 564 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4968 |