| National Provider Identifier [NPI]: | 1023054079 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | ROSITA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3400 SPRUCE ST |
| Street Address 2 Of The Provider | GROUND FLOOR DULLES |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 19104 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 4070 |
| Number Of Medicare Beneficiaries | 2681 |
| Total Submitted Charge Amount | 261515 |
| Total Medicare Allowed Amount | 76697.35 |
| Total Medicare Payment Amount | 58001.58 |
| Total Medicare Standardized Payment Amount | 56539.06 |
| 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 | 21 |
| Number Of Medical Services | 4070 |
| Number Of Medicare Beneficiaries With Medical Services | 2681 |
| Total Medical Submitted Charge Amount | 261515 |
| Total Medical Medicare Allowed Amount | 76697.35 |
| Total Medical Medicare Payment Amount | 58001.58 |
| Total Medical Medicare Standardized Payment Amount | 56539.06 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 566 |
| Number Of Beneficiaries Age 65 to 74 | 1214 |
| Number Of Beneficiaries Age 75 to 84 | 688 |
| Number Of Beneficiaries Age Greater 84 | 213 |
| Number Of Female Beneficiaries | 1262 |
| Number Of Male Beneficiaries | 1419 |
| Number Of Non Hispanic White Beneficiaries | 2011 |
| Number Of Black or African American Beneficiaries | 488 |
| Number Of AsianPacific Islander Beneficiaries | 64 |
| Number Of Hispanic Beneficiaries | 58 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 60 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2177 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 504 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.2827 |