| National Provider Identifier [NPI]: | 1255384020 |
| Last Name Of The Provider | SHUGOLL |
| First Name Of The Provider | WAYNE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 234 E GRAY ST |
| Street Address 2 Of The Provider | SUITE 554 |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402021914 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 4290 |
| Number Of Medicare Beneficiaries | 1979 |
| Total Submitted Charge Amount | 543146 |
| Total Medicare Allowed Amount | 253121.51 |
| Total Medicare Payment Amount | 186302.94 |
| Total Medicare Standardized Payment Amount | 205162.16 |
| 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 | 47 |
| Number Of Medical Services | 4290 |
| Number Of Medicare Beneficiaries With Medical Services | 1979 |
| Total Medical Submitted Charge Amount | 543146 |
| Total Medical Medicare Allowed Amount | 253121.51 |
| Total Medical Medicare Payment Amount | 186302.94 |
| Total Medical Medicare Standardized Payment Amount | 205162.16 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 282 |
| Number Of Beneficiaries Age 65 to 74 | 735 |
| Number Of Beneficiaries Age 75 to 84 | 622 |
| Number Of Beneficiaries Age Greater 84 | 340 |
| Number Of Female Beneficiaries | 1021 |
| Number Of Male Beneficiaries | 958 |
| Number Of Non Hispanic White Beneficiaries | 1737 |
| Number Of Black or African American Beneficiaries | 199 |
| 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 | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1624 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 355 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.6517 |