| National Provider Identifier [NPI]: | 1245291038 |
| Last Name Of The Provider | SHAVER |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 LILE CT |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | LITTLE ROCK |
| Zip Code Of The Provider | 722056242 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 3790 |
| Number Of Medicare Beneficiaries | 1298 |
| Total Submitted Charge Amount | 382195 |
| Total Medicare Allowed Amount | 134736.24 |
| Total Medicare Payment Amount | 103532.85 |
| Total Medicare Standardized Payment Amount | 83121.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 3790 |
| Number Of Medicare Beneficiaries With Medical Services | 1298 |
| Total Medical Submitted Charge Amount | 382195 |
| Total Medical Medicare Allowed Amount | 134736.24 |
| Total Medical Medicare Payment Amount | 103532.85 |
| Total Medical Medicare Standardized Payment Amount | 83121.23 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 258 |
| Number Of Beneficiaries Age 65 to 74 | 587 |
| Number Of Beneficiaries Age 75 to 84 | 352 |
| Number Of Beneficiaries Age Greater 84 | 101 |
| Number Of Female Beneficiaries | 714 |
| Number Of Male Beneficiaries | 584 |
| Number Of Non Hispanic White Beneficiaries | 1187 |
| Number Of Black or African American Beneficiaries | 90 |
| 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 | 1014 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 284 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2451 |