| National Provider Identifier [NPI]: | 1508838525 |
| Last Name Of The Provider | SHROFF-MEHTA |
| First Name Of The Provider | VIRAJ |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 31 ROCHE BROS WAY |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | NORTH EASTON |
| Zip Code Of The Provider | 023561032 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 4202 |
| Number Of Medicare Beneficiaries | 895 |
| Total Submitted Charge Amount | 513789 |
| Total Medicare Allowed Amount | 238888.89 |
| Total Medicare Payment Amount | 174570.91 |
| Total Medicare Standardized Payment Amount | 166776.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 40 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 8002 |
| Total Drug Medicare AllowedAmount | 6714.75 |
| Total Drug Medicare PaymentAmount | 5249.04 |
| Total Drug Medicare Standardized Payment Amount | 5249.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 4162 |
| Number Of Medicare Beneficiaries With Medical Services | 895 |
| Total Medical Submitted Charge Amount | 505787 |
| Total Medical Medicare Allowed Amount | 232174.14 |
| Total Medical Medicare Payment Amount | 169321.87 |
| Total Medical Medicare Standardized Payment Amount | 161527.74 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 499 |
| Number Of Beneficiaries Age 75 to 84 | 291 |
| Number Of Beneficiaries Age Greater 84 | 88 |
| Number Of Female Beneficiaries | 541 |
| Number Of Male Beneficiaries | 354 |
| Number Of Non Hispanic White Beneficiaries | 864 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 864 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9121 |