| National Provider Identifier [NPI]: | 1659590792 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | TANMAYA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 CARNIE BLVD |
| Street Address 2 Of The Provider | SUITE B-5 |
| City Of The Provider | VOORHEES |
| Zip Code Of The Provider | 080434512 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 149 |
| Number Of Services | 14609.7 |
| Number Of Medicare Beneficiaries | 2913 |
| Total Submitted Charge Amount | 2524508 |
| Total Medicare Allowed Amount | 515604.62 |
| Total Medicare Payment Amount | 392607.94 |
| Total Medicare Standardized Payment Amount | 368587.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 10543.7 |
| Number Of Medicare Beneficiaries With Drug Services | 306 |
| Total Drug Submitted ChargeAmount | 34293 |
| Total Drug Medicare AllowedAmount | 9394.07 |
| Total Drug Medicare PaymentAmount | 7348.67 |
| Total Drug Medicare Standardized Payment Amount | 7348.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 145 |
| Number Of Medical Services | 4066 |
| Number Of Medicare Beneficiaries With Medical Services | 2913 |
| Total Medical Submitted Charge Amount | 2490215 |
| Total Medical Medicare Allowed Amount | 506210.55 |
| Total Medical Medicare Payment Amount | 385259.27 |
| Total Medical Medicare Standardized Payment Amount | 361238.71 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 421 |
| Number Of Beneficiaries Age 65 to 74 | 1070 |
| Number Of Beneficiaries Age 75 to 84 | 838 |
| Number Of Beneficiaries Age Greater 84 | 584 |
| Number Of Female Beneficiaries | 1789 |
| Number Of Male Beneficiaries | 1124 |
| Number Of Non Hispanic White Beneficiaries | 2440 |
| Number Of Black or African American Beneficiaries | 308 |
| Number Of AsianPacific Islander Beneficiaries | 54 |
| Number Of Hispanic Beneficiaries | 67 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2523 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 390 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 1.6604 |