| National Provider Identifier [NPI]: | 1801835194 |
| Last Name Of The Provider | SHIN |
| First Name Of The Provider | STANLEY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 922 NORTHSIDE DR E |
| Street Address 2 Of The Provider | |
| City Of The Provider | STATESBORO |
| Zip Code Of The Provider | 304584839 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 6432 |
| Number Of Medicare Beneficiaries | 757 |
| Total Submitted Charge Amount | 1513563 |
| Total Medicare Allowed Amount | 490928.2 |
| Total Medicare Payment Amount | 376387.77 |
| Total Medicare Standardized Payment Amount | 403171.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 257 |
| Number Of Medicare Beneficiaries With Drug Services | 65 |
| Total Drug Submitted ChargeAmount | 20495 |
| Total Drug Medicare AllowedAmount | 13561.77 |
| Total Drug Medicare PaymentAmount | 10632.34 |
| Total Drug Medicare Standardized Payment Amount | 10632.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 6175 |
| Number Of Medicare Beneficiaries With Medical Services | 757 |
| Total Medical Submitted Charge Amount | 1493068 |
| Total Medical Medicare Allowed Amount | 477366.43 |
| Total Medical Medicare Payment Amount | 365755.43 |
| Total Medical Medicare Standardized Payment Amount | 392538.94 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 96 |
| Number Of Beneficiaries Age 65 to 74 | 319 |
| Number Of Beneficiaries Age 75 to 84 | 243 |
| Number Of Beneficiaries Age Greater 84 | 99 |
| Number Of Female Beneficiaries | 438 |
| Number Of Male Beneficiaries | 319 |
| Number Of Non Hispanic White Beneficiaries | 576 |
| Number Of Black or African American Beneficiaries | 169 |
| 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 | 540 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 217 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 75 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.721 |