| National Provider Identifier [NPI]: | 1215986864 |
| Last Name Of The Provider | SHORTEN |
| First Name Of The Provider | SUZANNE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1116 HORSHAM RD |
| Street Address 2 Of The Provider | SUITE 10 |
| City Of The Provider | AMBLER |
| Zip Code Of The Provider | 190021143 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 492 |
| Number Of Medicare Beneficiaries | 96 |
| Total Submitted Charge Amount | 45295 |
| Total Medicare Allowed Amount | 32382.47 |
| Total Medicare Payment Amount | 24500.91 |
| Total Medicare Standardized Payment Amount | 23528.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 53 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 3367 |
| Total Drug Medicare AllowedAmount | 2602.87 |
| Total Drug Medicare PaymentAmount | 2550.74 |
| Total Drug Medicare Standardized Payment Amount | 2550.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 439 |
| Number Of Medicare Beneficiaries With Medical Services | 96 |
| Total Medical Submitted Charge Amount | 41928 |
| Total Medical Medicare Allowed Amount | 29779.6 |
| Total Medical Medicare Payment Amount | 21950.17 |
| Total Medical Medicare Standardized Payment Amount | 20978.23 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 59 |
| Number Of Beneficiaries Age 75 to 84 | 19 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 79 |
| Number Of Male Beneficiaries | 17 |
| Number Of Non Hispanic White Beneficiaries | 53 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.782 |