| National Provider Identifier [NPI]: | 1508054248 |
| Last Name Of The Provider | SHUKLA |
| First Name Of The Provider | ANITA |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1900 CROWN COLONY DR |
| Street Address 2 Of The Provider | SUITE 301 |
| City Of The Provider | QUINCY |
| Zip Code Of The Provider | 021690979 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 1250 |
| Number Of Medicare Beneficiaries | 1000 |
| Total Submitted Charge Amount | 305995 |
| Total Medicare Allowed Amount | 165178.17 |
| Total Medicare Payment Amount | 121728.91 |
| Total Medicare Standardized Payment Amount | 112459.11 |
| 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 | 29 |
| Number Of Medical Services | 1250 |
| Number Of Medicare Beneficiaries With Medical Services | 1000 |
| Total Medical Submitted Charge Amount | 305995 |
| Total Medical Medicare Allowed Amount | 165178.17 |
| Total Medical Medicare Payment Amount | 121728.91 |
| Total Medical Medicare Standardized Payment Amount | 112459.11 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 140 |
| Number Of Beneficiaries Age 65 to 74 | 434 |
| Number Of Beneficiaries Age 75 to 84 | 280 |
| Number Of Beneficiaries Age Greater 84 | 146 |
| Number Of Female Beneficiaries | 637 |
| Number Of Male Beneficiaries | 363 |
| Number Of Non Hispanic White Beneficiaries | 869 |
| Number Of Black or African American Beneficiaries | 69 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 788 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 212 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1704 |