| National Provider Identifier [NPI]: | 1972547412 |
| Last Name Of The Provider | SHORE |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 94 MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CASSVILLE |
| Zip Code Of The Provider | 656251610 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 148 |
| Number Of Services | 5549 |
| Number Of Medicare Beneficiaries | 2411 |
| Total Submitted Charge Amount | 384728 |
| Total Medicare Allowed Amount | 132301.67 |
| Total Medicare Payment Amount | 98184.34 |
| Total Medicare Standardized Payment Amount | 103049.28 |
| 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 | 148 |
| Number Of Medical Services | 5549 |
| Number Of Medicare Beneficiaries With Medical Services | 2411 |
| Total Medical Submitted Charge Amount | 384728 |
| Total Medical Medicare Allowed Amount | 132301.67 |
| Total Medical Medicare Payment Amount | 98184.34 |
| Total Medical Medicare Standardized Payment Amount | 103049.28 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 622 |
| Number Of Beneficiaries Age 65 to 74 | 836 |
| Number Of Beneficiaries Age 75 to 84 | 652 |
| Number Of Beneficiaries Age Greater 84 | 301 |
| Number Of Female Beneficiaries | 1575 |
| Number Of Male Beneficiaries | 836 |
| Number Of Non Hispanic White Beneficiaries | 2344 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1656 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 755 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1367 |