National Provider Identifier [NPI]: |
1912141664 |
Last Name Of The Provider |
AMIN |
First Name Of The Provider |
SHALIN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1900 SULLIVAN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALY CITY |
Zip Code Of The Provider |
940152200 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
228 |
Number Of Services |
4084 |
Number Of Medicare Beneficiaries |
1944 |
Total Submitted Charge Amount |
1305460 |
Total Medicare Allowed Amount |
392372.34 |
Total Medicare Payment Amount |
305211.27 |
Total Medicare Standardized Payment Amount |
253729.13 |
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 |
228 |
Number Of Medical Services |
4084 |
Number Of Medicare Beneficiaries With Medical Services |
1944 |
Total Medical Submitted Charge Amount |
1305460 |
Total Medical Medicare Allowed Amount |
392372.34 |
Total Medical Medicare Payment Amount |
305211.27 |
Total Medical Medicare Standardized Payment Amount |
253729.13 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
201 |
Number Of Beneficiaries Age 65 to 74 |
643 |
Number Of Beneficiaries Age 75 to 84 |
617 |
Number Of Beneficiaries Age Greater 84 |
483 |
Number Of Female Beneficiaries |
1144 |
Number Of Male Beneficiaries |
800 |
Number Of Non Hispanic White Beneficiaries |
966 |
Number Of Black or African American Beneficiaries |
119 |
Number Of AsianPacific Islander Beneficiaries |
461 |
Number Of Hispanic Beneficiaries |
321 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1374 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
570 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.1647 |