| National Provider Identifier [NPI]: | 1932302759 |
| Last Name Of The Provider | SHAW |
| First Name Of The Provider | MICHELLE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 DIVISION ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | OREGON CITY |
| Zip Code Of The Provider | 970451527 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 389 |
| Number Of Medicare Beneficiaries | 221 |
| Total Submitted Charge Amount | 157524 |
| Total Medicare Allowed Amount | 41778.49 |
| Total Medicare Payment Amount | 32546.9 |
| Total Medicare Standardized Payment Amount | 32816.7 |
| 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 | 28 |
| Number Of Medical Services | 389 |
| Number Of Medicare Beneficiaries With Medical Services | 221 |
| Total Medical Submitted Charge Amount | 157524 |
| Total Medical Medicare Allowed Amount | 41778.49 |
| Total Medical Medicare Payment Amount | 32546.9 |
| Total Medical Medicare Standardized Payment Amount | 32816.7 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 72 |
| Number Of Beneficiaries Age 75 to 84 | 44 |
| Number Of Beneficiaries Age Greater 84 | 48 |
| Number Of Female Beneficiaries | 132 |
| Number Of Male Beneficiaries | 89 |
| Number Of Non Hispanic White Beneficiaries | 205 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 145 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 76 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6235 |