| National Provider Identifier [NPI]: | 1154516268 |
| Last Name Of The Provider | JOG |
| First Name Of The Provider | SHILPA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3901 HOYT AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | EVERETT |
| Zip Code Of The Provider | 982014918 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 104 |
| Number Of Services | 1171 |
| Number Of Medicare Beneficiaries | 135 |
| Total Submitted Charge Amount | 93933.25 |
| Total Medicare Allowed Amount | 41801.89 |
| Total Medicare Payment Amount | 31641.66 |
| Total Medicare Standardized Payment Amount | 33103.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 36 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 1822.5 |
| Total Drug Medicare AllowedAmount | 986.64 |
| Total Drug Medicare PaymentAmount | 958.42 |
| Total Drug Medicare Standardized Payment Amount | 958.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 97 |
| Number Of Medical Services | 1135 |
| Number Of Medicare Beneficiaries With Medical Services | 135 |
| Total Medical Submitted Charge Amount | 92110.75 |
| Total Medical Medicare Allowed Amount | 40815.25 |
| Total Medical Medicare Payment Amount | 30683.24 |
| Total Medical Medicare Standardized Payment Amount | 32145.5 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 47 |
| Number Of Beneficiaries Age 75 to 84 | 40 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 101 |
| Number Of Male Beneficiaries | 34 |
| Number Of Non Hispanic White Beneficiaries | 113 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 99 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2699 |