| National Provider Identifier [NPI]: | 1710980602 |
| Last Name Of The Provider | SHAHAN |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4960 W NEWBERRY RD |
| Street Address 2 Of The Provider | STE 280 |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 326072201 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 222 |
| Number Of Services | 8440 |
| Number Of Medicare Beneficiaries | 2720 |
| Total Submitted Charge Amount | 516152 |
| Total Medicare Allowed Amount | 213802.7 |
| Total Medicare Payment Amount | 165785.35 |
| Total Medicare Standardized Payment Amount | 167678.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3451 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 9302 |
| Total Drug Medicare AllowedAmount | 637.48 |
| Total Drug Medicare PaymentAmount | 489.52 |
| Total Drug Medicare Standardized Payment Amount | 489.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 219 |
| Number Of Medical Services | 4989 |
| Number Of Medicare Beneficiaries With Medical Services | 2720 |
| Total Medical Submitted Charge Amount | 506850 |
| Total Medical Medicare Allowed Amount | 213165.22 |
| Total Medical Medicare Payment Amount | 165295.83 |
| Total Medical Medicare Standardized Payment Amount | 167188.57 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 493 |
| Number Of Beneficiaries Age 65 to 74 | 879 |
| Number Of Beneficiaries Age 75 to 84 | 891 |
| Number Of Beneficiaries Age Greater 84 | 457 |
| Number Of Female Beneficiaries | 1657 |
| Number Of Male Beneficiaries | 1063 |
| Number Of Non Hispanic White Beneficiaries | 2263 |
| Number Of Black or African American Beneficiaries | 365 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 64 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1804 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 916 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9617 |