| National Provider Identifier [NPI]: | 1538106133 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | POORVI |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4003 N ROXBORO ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DURHAM |
| Zip Code Of The Provider | 277042119 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 1411 |
| Number Of Medicare Beneficiaries | 141 |
| Total Submitted Charge Amount | 154614 |
| Total Medicare Allowed Amount | 72599.4 |
| Total Medicare Payment Amount | 56673.12 |
| Total Medicare Standardized Payment Amount | 59778.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 126 |
| Number Of Medicare Beneficiaries With Drug Services | 80 |
| Total Drug Submitted ChargeAmount | 9718 |
| Total Drug Medicare AllowedAmount | 4958.45 |
| Total Drug Medicare PaymentAmount | 4657.36 |
| Total Drug Medicare Standardized Payment Amount | 4657.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 1285 |
| Number Of Medicare Beneficiaries With Medical Services | 141 |
| Total Medical Submitted Charge Amount | 144896 |
| Total Medical Medicare Allowed Amount | 67640.95 |
| Total Medical Medicare Payment Amount | 52015.76 |
| Total Medical Medicare Standardized Payment Amount | 55120.83 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 79 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 100 |
| Number Of Male Beneficiaries | 41 |
| Number Of Non Hispanic White Beneficiaries | 83 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 126 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 18 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0182 |