| National Provider Identifier [NPI]: | 1821011594 |
| Last Name Of The Provider | SHIN |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1345 UNITY PL |
| Street Address 2 Of The Provider | SUITE 145 |
| City Of The Provider | LAFAYETTE |
| Zip Code Of The Provider | 479055760 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 6408 |
| Number Of Medicare Beneficiaries | 859 |
| Total Submitted Charge Amount | 1233853 |
| Total Medicare Allowed Amount | 447300.64 |
| Total Medicare Payment Amount | 328966.58 |
| Total Medicare Standardized Payment Amount | 358171.42 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 160 |
| Number Of Beneficiaries Age 65 to 74 | 270 |
| Number Of Beneficiaries Age 75 to 84 | 270 |
| Number Of Beneficiaries Age Greater 84 | 159 |
| Number Of Female Beneficiaries | 499 |
| Number Of Male Beneficiaries | 360 |
| Number Of Non Hispanic White Beneficiaries | 811 |
| Number Of Black or African American Beneficiaries | 25 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 620 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 239 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 3.2665 |