| National Provider Identifier [NPI]: | 1902002280 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | SHAAN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 CHAPEL ST APT B401 |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROOKLINE |
| Zip Code Of The Provider | 024467473 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 181 |
| Number Of Services | 5393 |
| Number Of Medicare Beneficiaries | 2386 |
| Total Submitted Charge Amount | 690690 |
| Total Medicare Allowed Amount | 177488.97 |
| Total Medicare Payment Amount | 137074.91 |
| Total Medicare Standardized Payment Amount | 142615.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1706 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 2281 |
| Total Drug Medicare AllowedAmount | 1017.16 |
| Total Drug Medicare PaymentAmount | 797.45 |
| Total Drug Medicare Standardized Payment Amount | 797.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 177 |
| Number Of Medical Services | 3687 |
| Number Of Medicare Beneficiaries With Medical Services | 2386 |
| Total Medical Submitted Charge Amount | 688409 |
| Total Medical Medicare Allowed Amount | 176471.81 |
| Total Medical Medicare Payment Amount | 136277.46 |
| Total Medical Medicare Standardized Payment Amount | 141817.74 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 359 |
| Number Of Beneficiaries Age 65 to 74 | 962 |
| Number Of Beneficiaries Age 75 to 84 | 706 |
| Number Of Beneficiaries Age Greater 84 | 359 |
| Number Of Female Beneficiaries | 1573 |
| Number Of Male Beneficiaries | 813 |
| Number Of Non Hispanic White Beneficiaries | 1641 |
| Number Of Black or African American Beneficiaries | 613 |
| Number Of AsianPacific Islander Beneficiaries | 44 |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1996 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 390 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.5371 |