| National Provider Identifier [NPI]: | 1881624245 |
| Last Name Of The Provider | DAVE |
| First Name Of The Provider | SHILPA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1870 W GALENA BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | AURORA |
| Zip Code Of The Provider | 605064356 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 92 |
| Number Of Services | 5861 |
| Number Of Medicare Beneficiaries | 417 |
| Total Submitted Charge Amount | 555647 |
| Total Medicare Allowed Amount | 207655.46 |
| Total Medicare Payment Amount | 168943.71 |
| Total Medicare Standardized Payment Amount | 164422.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 154 |
| Number Of Medicare Beneficiaries With Drug Services | 113 |
| Total Drug Submitted ChargeAmount | 5941 |
| Total Drug Medicare AllowedAmount | 4326.78 |
| Total Drug Medicare PaymentAmount | 4227.57 |
| Total Drug Medicare Standardized Payment Amount | 4227.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 5707 |
| Number Of Medicare Beneficiaries With Medical Services | 417 |
| Total Medical Submitted Charge Amount | 549706 |
| Total Medical Medicare Allowed Amount | 203328.68 |
| Total Medical Medicare Payment Amount | 164716.14 |
| Total Medical Medicare Standardized Payment Amount | 160194.45 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 223 |
| Number Of Beneficiaries Age 75 to 84 | 102 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 354 |
| Number Of Male Beneficiaries | 63 |
| Number Of Non Hispanic White Beneficiaries | 338 |
| Number Of Black or African American Beneficiaries | 33 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 359 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0049 |