| National Provider Identifier [NPI]: | 1902859457 |
| Last Name Of The Provider | SHUBE |
| First Name Of The Provider | SAMUEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2700 UNIVERSITY SQUARE DRIVE |
| Street Address 2 Of The Provider | RADIOLOGY ASSOCIATES OF TAMPA |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336125513 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 288 |
| Number Of Services | 4971 |
| Number Of Medicare Beneficiaries | 1632 |
| Total Submitted Charge Amount | 1471718.5 |
| Total Medicare Allowed Amount | 309406.8 |
| Total Medicare Payment Amount | 237532.95 |
| Total Medicare Standardized Payment Amount | 236603.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1465 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 1977.5 |
| Total Drug Medicare AllowedAmount | 391.5 |
| Total Drug Medicare PaymentAmount | 306.95 |
| Total Drug Medicare Standardized Payment Amount | 306.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 286 |
| Number Of Medical Services | 3506 |
| Number Of Medicare Beneficiaries With Medical Services | 1631 |
| Total Medical Submitted Charge Amount | 1469741 |
| Total Medical Medicare Allowed Amount | 309015.3 |
| Total Medical Medicare Payment Amount | 237226 |
| Total Medical Medicare Standardized Payment Amount | 236296.23 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 488 |
| Number Of Beneficiaries Age 65 to 74 | 531 |
| Number Of Beneficiaries Age 75 to 84 | 396 |
| Number Of Beneficiaries Age Greater 84 | 217 |
| Number Of Female Beneficiaries | 822 |
| Number Of Male Beneficiaries | 810 |
| Number Of Non Hispanic White Beneficiaries | 1174 |
| Number Of Black or African American Beneficiaries | 243 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 179 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1115 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 517 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 61 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 3.1836 |