| National Provider Identifier [NPI]: | 1154362770 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | SANDEEP |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1008 NW 139TH STREET PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | EDMOND |
| Zip Code Of The Provider | 730139791 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 14341 |
| Number Of Medicare Beneficiaries | 867 |
| Total Submitted Charge Amount | 4182676 |
| Total Medicare Allowed Amount | 2608211.02 |
| Total Medicare Payment Amount | 2007224.78 |
| Total Medicare Standardized Payment Amount | 2063653.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 6460 |
| Number Of Medicare Beneficiaries With Drug Services | 403 |
| Total Drug Submitted ChargeAmount | 2773456 |
| Total Drug Medicare AllowedAmount | 1818622.66 |
| Total Drug Medicare PaymentAmount | 1413396.41 |
| Total Drug Medicare Standardized Payment Amount | 1413396.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 7881 |
| Number Of Medicare Beneficiaries With Medical Services | 867 |
| Total Medical Submitted Charge Amount | 1409220 |
| Total Medical Medicare Allowed Amount | 789588.36 |
| Total Medical Medicare Payment Amount | 593828.37 |
| Total Medical Medicare Standardized Payment Amount | 650257.18 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 322 |
| Number Of Beneficiaries Age 75 to 84 | 305 |
| Number Of Beneficiaries Age Greater 84 | 187 |
| Number Of Female Beneficiaries | 480 |
| Number Of Male Beneficiaries | 387 |
| Number Of Non Hispanic White Beneficiaries | 787 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 26 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 785 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 82 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2456 |