| National Provider Identifier [NPI]: | 1124023452 |
| Last Name Of The Provider | SHAFFER |
| First Name Of The Provider | DON |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 340 KENNESTONE HOSPITAL BLVD |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | MARIETTA |
| Zip Code Of The Provider | 300601121 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 125 |
| Number Of Services | 116192 |
| Number Of Medicare Beneficiaries | 594 |
| Total Submitted Charge Amount | 4552190 |
| Total Medicare Allowed Amount | 1619909.63 |
| Total Medicare Payment Amount | 1258901.76 |
| Total Medicare Standardized Payment Amount | 1262421.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 70 |
| Number Of Drug Services | 108330 |
| Number Of Medicare Beneficiaries With Drug Services | 194 |
| Total Drug Submitted ChargeAmount | 3442649 |
| Total Drug Medicare AllowedAmount | 1253451.25 |
| Total Drug Medicare PaymentAmount | 979989.18 |
| Total Drug Medicare Standardized Payment Amount | 979989.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 7862 |
| Number Of Medicare Beneficiaries With Medical Services | 594 |
| Total Medical Submitted Charge Amount | 1109541 |
| Total Medical Medicare Allowed Amount | 366458.38 |
| Total Medical Medicare Payment Amount | 278912.58 |
| Total Medical Medicare Standardized Payment Amount | 282431.88 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 261 |
| Number Of Beneficiaries Age 75 to 84 | 180 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 326 |
| Number Of Male Beneficiaries | 268 |
| Number Of Non Hispanic White Beneficiaries | 534 |
| Number Of Black or African American Beneficiaries | 46 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 511 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 83 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 40 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.0059 |