| National Provider Identifier [NPI]: | 1992752299 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | GHANSHYAM |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5999 NEW WILKE RD |
| Street Address 2 Of The Provider | SUITE 200 BLDG 2 |
| City Of The Provider | ROLLING MEADOWS |
| Zip Code Of The Provider | 600084506 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 4957 |
| Number Of Medicare Beneficiaries | 1132 |
| Total Submitted Charge Amount | 502670 |
| Total Medicare Allowed Amount | 301196.85 |
| Total Medicare Payment Amount | 228355.71 |
| Total Medicare Standardized Payment Amount | 215968.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 526 |
| Number Of Medicare Beneficiaries With Drug Services | 287 |
| Total Drug Submitted ChargeAmount | 29215 |
| Total Drug Medicare AllowedAmount | 16666.92 |
| Total Drug Medicare PaymentAmount | 15770.25 |
| Total Drug Medicare Standardized Payment Amount | 15770.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 4431 |
| Number Of Medicare Beneficiaries With Medical Services | 1132 |
| Total Medical Submitted Charge Amount | 473455 |
| Total Medical Medicare Allowed Amount | 284529.93 |
| Total Medical Medicare Payment Amount | 212585.46 |
| Total Medical Medicare Standardized Payment Amount | 200198.23 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 381 |
| Number Of Beneficiaries Age 75 to 84 | 430 |
| Number Of Beneficiaries Age Greater 84 | 282 |
| Number Of Female Beneficiaries | 633 |
| Number Of Male Beneficiaries | 499 |
| Number Of Non Hispanic White Beneficiaries | 1085 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1086 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.173 |