| National Provider Identifier [NPI]: | 1144258757 |
| Last Name Of The Provider | SHORE |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4701 RANDOLPH RD |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | ROCKVILLE |
| Zip Code Of The Provider | 208522257 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 5815 |
| Number Of Medicare Beneficiaries | 816 |
| Total Submitted Charge Amount | 866360 |
| Total Medicare Allowed Amount | 501729.83 |
| Total Medicare Payment Amount | 373463.09 |
| Total Medicare Standardized Payment Amount | 335715.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 930 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 3360 |
| Total Drug Medicare AllowedAmount | 1431.8 |
| Total Drug Medicare PaymentAmount | 1004.88 |
| Total Drug Medicare Standardized Payment Amount | 1004.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 4885 |
| Number Of Medicare Beneficiaries With Medical Services | 816 |
| Total Medical Submitted Charge Amount | 863000 |
| Total Medical Medicare Allowed Amount | 500298.03 |
| Total Medical Medicare Payment Amount | 372458.21 |
| Total Medical Medicare Standardized Payment Amount | 334710.91 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 298 |
| Number Of Beneficiaries Age 75 to 84 | 277 |
| Number Of Beneficiaries Age Greater 84 | 207 |
| Number Of Female Beneficiaries | 449 |
| Number Of Male Beneficiaries | 367 |
| Number Of Non Hispanic White Beneficiaries | 689 |
| Number Of Black or African American Beneficiaries | 51 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 777 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1252 |