| National Provider Identifier [NPI]: | 1952371429 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | BIREN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2799 W GRAND BLVD |
| Street Address 2 Of The Provider | HENRY FORD HOSPITAL DEPARTMENT OF RADIOLOGY |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 482022608 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 1372 |
| Number Of Medicare Beneficiaries | 1229 |
| Total Submitted Charge Amount | 172428 |
| Total Medicare Allowed Amount | 53885.27 |
| Total Medicare Payment Amount | 47230.56 |
| Total Medicare Standardized Payment Amount | 45736.56 |
| 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 | 42 |
| Number Of Medical Services | 1372 |
| Number Of Medicare Beneficiaries With Medical Services | 1229 |
| Total Medical Submitted Charge Amount | 172428 |
| Total Medical Medicare Allowed Amount | 53885.27 |
| Total Medical Medicare Payment Amount | 47230.56 |
| Total Medical Medicare Standardized Payment Amount | 45736.56 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 272 |
| Number Of Beneficiaries Age 65 to 74 | 588 |
| Number Of Beneficiaries Age 75 to 84 | 277 |
| Number Of Beneficiaries Age Greater 84 | 92 |
| Number Of Female Beneficiaries | 1084 |
| Number Of Male Beneficiaries | 145 |
| Number Of Non Hispanic White Beneficiaries | 575 |
| Number Of Black or African American Beneficiaries | 582 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 930 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 299 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3608 |