| National Provider Identifier [NPI]: | 1861408361 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | GAURANG |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 EAST MEDICAL CENTER DR |
| Street Address 2 Of The Provider | B1 FLOOR UNIVERSITY HOSP RECP C |
| City Of The Provider | ANN ARBOR |
| Zip Code Of The Provider | 481095030 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 3452 |
| Number Of Medicare Beneficiaries | 2213 |
| Total Submitted Charge Amount | 736463 |
| Total Medicare Allowed Amount | 155854.61 |
| Total Medicare Payment Amount | 119725.59 |
| Total Medicare Standardized Payment Amount | 119121.77 |
| 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 | 109 |
| Number Of Medical Services | 3452 |
| Number Of Medicare Beneficiaries With Medical Services | 2213 |
| Total Medical Submitted Charge Amount | 736463 |
| Total Medical Medicare Allowed Amount | 155854.61 |
| Total Medical Medicare Payment Amount | 119725.59 |
| Total Medical Medicare Standardized Payment Amount | 119121.77 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 547 |
| Number Of Beneficiaries Age 65 to 74 | 782 |
| Number Of Beneficiaries Age 75 to 84 | 534 |
| Number Of Beneficiaries Age Greater 84 | 350 |
| Number Of Female Beneficiaries | 1212 |
| Number Of Male Beneficiaries | 1001 |
| Number Of Non Hispanic White Beneficiaries | 1817 |
| Number Of Black or African American Beneficiaries | 297 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1540 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 673 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 1.9569 |