| National Provider Identifier [NPI]: | 1649418369 |
| Last Name Of The Provider | SHETH |
| First Name Of The Provider | JIGNESH |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | M.D., M.P.H. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5 S WASHINGTON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | JERMYN |
| Zip Code Of The Provider | 184331121 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 2824 |
| Number Of Medicare Beneficiaries | 300 |
| Total Submitted Charge Amount | 188255.15 |
| Total Medicare Allowed Amount | 130362.07 |
| Total Medicare Payment Amount | 99589.83 |
| Total Medicare Standardized Payment Amount | 104085.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 329 |
| Number Of Medicare Beneficiaries With Drug Services | 89 |
| Total Drug Submitted ChargeAmount | 8876 |
| Total Drug Medicare AllowedAmount | 4919.23 |
| Total Drug Medicare PaymentAmount | 4410.47 |
| Total Drug Medicare Standardized Payment Amount | 4410.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 2495 |
| Number Of Medicare Beneficiaries With Medical Services | 300 |
| Total Medical Submitted Charge Amount | 179379.15 |
| Total Medical Medicare Allowed Amount | 125442.84 |
| Total Medical Medicare Payment Amount | 95179.36 |
| Total Medical Medicare Standardized Payment Amount | 99674.94 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 117 |
| Number Of Beneficiaries Age 65 to 74 | 103 |
| Number Of Beneficiaries Age 75 to 84 | 53 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 169 |
| Number Of Male Beneficiaries | 131 |
| Number Of Non Hispanic White Beneficiaries | 278 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 149 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 151 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4893 |