| National Provider Identifier [NPI]: | 1467614826 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | KANT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2 COLUMBIA DR |
| Street Address 2 Of The Provider | J402 |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336063508 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 1349 |
| Number Of Medicare Beneficiaries | 921 |
| Total Submitted Charge Amount | 493497 |
| Total Medicare Allowed Amount | 144363.86 |
| Total Medicare Payment Amount | 111335.12 |
| Total Medicare Standardized Payment Amount | 114678.82 |
| 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 | 21 |
| Number Of Medical Services | 1349 |
| Number Of Medicare Beneficiaries With Medical Services | 921 |
| Total Medical Submitted Charge Amount | 493497 |
| Total Medical Medicare Allowed Amount | 144363.86 |
| Total Medical Medicare Payment Amount | 111335.12 |
| Total Medical Medicare Standardized Payment Amount | 114678.82 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 355 |
| Number Of Beneficiaries Age 65 to 74 | 274 |
| Number Of Beneficiaries Age 75 to 84 | 191 |
| Number Of Beneficiaries Age Greater 84 | 101 |
| Number Of Female Beneficiaries | 526 |
| Number Of Male Beneficiaries | 395 |
| Number Of Non Hispanic White Beneficiaries | 455 |
| Number Of Black or African American Beneficiaries | 404 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 482 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 439 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.2995 |