| National Provider Identifier [NPI]: | 1740226505 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | SANJAYKUMAR |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2300 HOSPITAL DR |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | BOSSIER CITY |
| Zip Code Of The Provider | 711112394 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 94 |
| Number Of Services | 7502 |
| Number Of Medicare Beneficiaries | 809 |
| Total Submitted Charge Amount | 499619 |
| Total Medicare Allowed Amount | 240131.59 |
| Total Medicare Payment Amount | 177483.72 |
| Total Medicare Standardized Payment Amount | 186676.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 2099 |
| Number Of Medicare Beneficiaries With Drug Services | 345 |
| Total Drug Submitted ChargeAmount | 37353 |
| Total Drug Medicare AllowedAmount | 9912.65 |
| Total Drug Medicare PaymentAmount | 7968.51 |
| Total Drug Medicare Standardized Payment Amount | 7968.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 5403 |
| Number Of Medicare Beneficiaries With Medical Services | 808 |
| Total Medical Submitted Charge Amount | 462266 |
| Total Medical Medicare Allowed Amount | 230218.94 |
| Total Medical Medicare Payment Amount | 169515.21 |
| Total Medical Medicare Standardized Payment Amount | 178708.43 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 90 |
| Number Of Beneficiaries Age 65 to 74 | 330 |
| Number Of Beneficiaries Age 75 to 84 | 288 |
| Number Of Beneficiaries Age Greater 84 | 101 |
| Number Of Female Beneficiaries | 474 |
| Number Of Male Beneficiaries | 335 |
| Number Of Non Hispanic White Beneficiaries | 622 |
| Number Of Black or African American Beneficiaries | 160 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 648 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 161 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3847 |