| National Provider Identifier [NPI]: | 1861643801 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | CHIRAG |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1725 W HARRISON ST STE 118 |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606123835 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 2523 |
| Number Of Medicare Beneficiaries | 523 |
| Total Submitted Charge Amount | 369695 |
| Total Medicare Allowed Amount | 176932.75 |
| Total Medicare Payment Amount | 137412.3 |
| Total Medicare Standardized Payment Amount | 129136.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 772 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 33200 |
| Total Drug Medicare AllowedAmount | 16791.63 |
| Total Drug Medicare PaymentAmount | 13145.83 |
| Total Drug Medicare Standardized Payment Amount | 13145.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 1751 |
| Number Of Medicare Beneficiaries With Medical Services | 523 |
| Total Medical Submitted Charge Amount | 336495 |
| Total Medical Medicare Allowed Amount | 160141.12 |
| Total Medical Medicare Payment Amount | 124266.47 |
| Total Medical Medicare Standardized Payment Amount | 115990.7 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 130 |
| Number Of Beneficiaries Age 65 to 74 | 190 |
| Number Of Beneficiaries Age 75 to 84 | 136 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 291 |
| Number Of Male Beneficiaries | 232 |
| Number Of Non Hispanic White Beneficiaries | 260 |
| Number Of Black or African American Beneficiaries | 191 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 60 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 328 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 195 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 34 |
| Average HCC Risk Score Of Beneficiaries | 2.3112 |