| National Provider Identifier [NPI]: | 1306878699 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | DEEPAK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6350 STEVENS FOREST RD |
| Street Address 2 Of The Provider | SUITES 102 & 105 |
| City Of The Provider | COLUMBIA |
| Zip Code Of The Provider | 210463231 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 705 |
| Number Of Medicare Beneficiaries | 184 |
| Total Submitted Charge Amount | 99079 |
| Total Medicare Allowed Amount | 43778.66 |
| Total Medicare Payment Amount | 31940.99 |
| Total Medicare Standardized Payment Amount | 30589.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 116 |
| Number Of Medicare Beneficiaries With Drug Services | 64 |
| Total Drug Submitted ChargeAmount | 4423 |
| Total Drug Medicare AllowedAmount | 1979.11 |
| Total Drug Medicare PaymentAmount | 1918.76 |
| Total Drug Medicare Standardized Payment Amount | 1918.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 589 |
| Number Of Medicare Beneficiaries With Medical Services | 184 |
| Total Medical Submitted Charge Amount | 94656 |
| Total Medical Medicare Allowed Amount | 41799.55 |
| Total Medical Medicare Payment Amount | 30022.23 |
| Total Medical Medicare Standardized Payment Amount | 28670.54 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 94 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 102 |
| Number Of Male Beneficiaries | 82 |
| Number Of Non Hispanic White Beneficiaries | 108 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 149 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0149 |