| National Provider Identifier [NPI]: | 1235387259 |
| Last Name Of The Provider | SHANKAR |
| First Name Of The Provider | RAVI |
| 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 | 181 S BUENA VISTA ST |
| Street Address 2 Of The Provider | 4TH FLOOR |
| City Of The Provider | BURBANK |
| Zip Code Of The Provider | 915054504 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 3288 |
| Number Of Medicare Beneficiaries | 77 |
| Total Submitted Charge Amount | 149463.52 |
| Total Medicare Allowed Amount | 63010.87 |
| Total Medicare Payment Amount | 50230.1 |
| Total Medicare Standardized Payment Amount | 46599.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 21 |
| Number Of Drug Services | 2494 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 78202.15 |
| Total Drug Medicare AllowedAmount | 23055.76 |
| Total Drug Medicare PaymentAmount | 18089.57 |
| Total Drug Medicare Standardized Payment Amount | 18089.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 794 |
| Number Of Medicare Beneficiaries With Medical Services | 76 |
| Total Medical Submitted Charge Amount | 71261.37 |
| Total Medical Medicare Allowed Amount | 39955.11 |
| Total Medical Medicare Payment Amount | 32140.53 |
| Total Medical Medicare Standardized Payment Amount | 28509.8 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 24 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 47 |
| Number Of Male Beneficiaries | 30 |
| Number Of Non Hispanic White Beneficiaries | 65 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 52 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 45 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.932 |