| National Provider Identifier [NPI]: | 1881899557 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | RUTUL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 929 BARCLAY DR |
| Street Address 2 Of The Provider | SUITE A-220 |
| City Of The Provider | FLORENCE |
| Zip Code Of The Provider | 295017399 |
| State Code Of The Provider | SC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 1607 |
| Number Of Medicare Beneficiaries | 457 |
| Total Submitted Charge Amount | 632059.55 |
| Total Medicare Allowed Amount | 211185.65 |
| Total Medicare Payment Amount | 162726.23 |
| Total Medicare Standardized Payment Amount | 167771.16 |
| 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 | 46 |
| Number Of Medical Services | 1607 |
| Number Of Medicare Beneficiaries With Medical Services | 457 |
| Total Medical Submitted Charge Amount | 632059.55 |
| Total Medical Medicare Allowed Amount | 211185.65 |
| Total Medical Medicare Payment Amount | 162726.23 |
| Total Medical Medicare Standardized Payment Amount | 167771.16 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 83 |
| Number Of Beneficiaries Age 65 to 74 | 163 |
| Number Of Beneficiaries Age 75 to 84 | 139 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 249 |
| Number Of Male Beneficiaries | 208 |
| Number Of Non Hispanic White Beneficiaries | 289 |
| Number Of Black or African American Beneficiaries | |
| 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 | 353 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 24 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 58 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 49 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.3304 |