| National Provider Identifier [NPI]: | 1124090782 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | ABHIJIT |
| 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 | 19829 N 27TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850274001 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 111 |
| Number Of Services | 4742 |
| Number Of Medicare Beneficiaries | 3337 |
| Total Submitted Charge Amount | 614015.89 |
| Total Medicare Allowed Amount | 169988.57 |
| Total Medicare Payment Amount | 129719.63 |
| Total Medicare Standardized Payment Amount | 128883.64 |
| 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 | 111 |
| Number Of Medical Services | 4742 |
| Number Of Medicare Beneficiaries With Medical Services | 3337 |
| Total Medical Submitted Charge Amount | 614015.89 |
| Total Medical Medicare Allowed Amount | 169988.57 |
| Total Medical Medicare Payment Amount | 129719.63 |
| Total Medical Medicare Standardized Payment Amount | 128883.64 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 647 |
| Number Of Beneficiaries Age 65 to 74 | 1108 |
| Number Of Beneficiaries Age 75 to 84 | 1007 |
| Number Of Beneficiaries Age Greater 84 | 575 |
| Number Of Female Beneficiaries | 1936 |
| Number Of Male Beneficiaries | 1401 |
| Number Of Non Hispanic White Beneficiaries | 2714 |
| Number Of Black or African American Beneficiaries | 72 |
| Number Of AsianPacific Islander Beneficiaries | 33 |
| Number Of Hispanic Beneficiaries | 359 |
| Number Of American Indian Alaska Native Beneficiaries | 127 |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2404 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 933 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7426 |