| National Provider Identifier [NPI]: | 1265423453 |
| Last Name Of The Provider | SHORE |
| First Name Of The Provider | NEAL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DR |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 823 82ND PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | MYRTLE BEACH |
| Zip Code Of The Provider | 295724607 |
| State Code Of The Provider | SC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 154 |
| Number Of Services | 49899 |
| Number Of Medicare Beneficiaries | 1306 |
| Total Submitted Charge Amount | 3312247.17 |
| Total Medicare Allowed Amount | 1350128.95 |
| Total Medicare Payment Amount | 1036341.8 |
| Total Medicare Standardized Payment Amount | 1072997.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 37285 |
| Number Of Medicare Beneficiaries With Drug Services | 185 |
| Total Drug Submitted ChargeAmount | 1194378.12 |
| Total Drug Medicare AllowedAmount | 672644.59 |
| Total Drug Medicare PaymentAmount | 523972.54 |
| Total Drug Medicare Standardized Payment Amount | 523972.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 138 |
| Number Of Medical Services | 12614 |
| Number Of Medicare Beneficiaries With Medical Services | 1306 |
| Total Medical Submitted Charge Amount | 2117869.05 |
| Total Medical Medicare Allowed Amount | 677484.36 |
| Total Medical Medicare Payment Amount | 512369.26 |
| Total Medical Medicare Standardized Payment Amount | 549025.37 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 648 |
| Number Of Beneficiaries Age 75 to 84 | 444 |
| Number Of Beneficiaries Age Greater 84 | 143 |
| Number Of Female Beneficiaries | 269 |
| Number Of Male Beneficiaries | 1037 |
| Number Of Non Hispanic White Beneficiaries | 1200 |
| Number Of Black or African American Beneficiaries | 66 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1267 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 33 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0701 |