| National Provider Identifier [NPI]: | 1407940869 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | SIDDHI |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1250 E MARSHALL STREET |
| Street Address 2 Of The Provider | RADIOLOGY |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 232980470 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 3477 |
| Number Of Medicare Beneficiaries | 1958 |
| Total Submitted Charge Amount | 349007 |
| Total Medicare Allowed Amount | 86584.77 |
| Total Medicare Payment Amount | 61799.54 |
| Total Medicare Standardized Payment Amount | 65755.43 |
| 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 | 87 |
| Number Of Medical Services | 3477 |
| Number Of Medicare Beneficiaries With Medical Services | 1958 |
| Total Medical Submitted Charge Amount | 349007 |
| Total Medical Medicare Allowed Amount | 86584.77 |
| Total Medical Medicare Payment Amount | 61799.54 |
| Total Medical Medicare Standardized Payment Amount | 65755.43 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 850 |
| Number Of Beneficiaries Age 65 to 74 | 614 |
| Number Of Beneficiaries Age 75 to 84 | 345 |
| Number Of Beneficiaries Age Greater 84 | 149 |
| Number Of Female Beneficiaries | 1004 |
| Number Of Male Beneficiaries | 954 |
| Number Of Non Hispanic White Beneficiaries | 731 |
| Number Of Black or African American Beneficiaries | 1167 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 972 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 986 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.6214 |