National Provider Identifier [NPI]: |
1154380988 |
Last Name Of The Provider |
SHAH |
First Name Of The Provider |
ASHISH |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
350 1ST ST N |
Street Address 2 Of The Provider |
|
City Of The Provider |
WINTER HAVEN |
Zip Code Of The Provider |
338814113 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
108 |
Number Of Services |
7452 |
Number Of Medicare Beneficiaries |
892 |
Total Submitted Charge Amount |
612520 |
Total Medicare Allowed Amount |
542565.57 |
Total Medicare Payment Amount |
404887.62 |
Total Medicare Standardized Payment Amount |
408615.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
918 |
Number Of Medicare Beneficiaries With Drug Services |
350 |
Total Drug Submitted ChargeAmount |
21158 |
Total Drug Medicare AllowedAmount |
14636 |
Total Drug Medicare PaymentAmount |
12051.26 |
Total Drug Medicare Standardized Payment Amount |
12051.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
97 |
Number Of Medical Services |
6534 |
Number Of Medicare Beneficiaries With Medical Services |
892 |
Total Medical Submitted Charge Amount |
591362 |
Total Medical Medicare Allowed Amount |
527929.57 |
Total Medical Medicare Payment Amount |
392836.36 |
Total Medical Medicare Standardized Payment Amount |
396563.97 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
329 |
Number Of Beneficiaries Age 75 to 84 |
326 |
Number Of Beneficiaries Age Greater 84 |
145 |
Number Of Female Beneficiaries |
463 |
Number Of Male Beneficiaries |
429 |
Number Of Non Hispanic White Beneficiaries |
778 |
Number Of Black or African American Beneficiaries |
70 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
716 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
176 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.8625 |