| National Provider Identifier [NPI]: | 1285652172 |
| Last Name Of The Provider | SHEKUT |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2142 N COVE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TOLEDO |
| Zip Code Of The Provider | 436063895 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 171 |
| Number Of Services | 4725 |
| Number Of Medicare Beneficiaries | 3186 |
| Total Submitted Charge Amount | 438068 |
| Total Medicare Allowed Amount | 141259.67 |
| Total Medicare Payment Amount | 105089.31 |
| Total Medicare Standardized Payment Amount | 109392.74 |
| 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 | 171 |
| Number Of Medical Services | 4725 |
| Number Of Medicare Beneficiaries With Medical Services | 3186 |
| Total Medical Submitted Charge Amount | 438068 |
| Total Medical Medicare Allowed Amount | 141259.67 |
| Total Medical Medicare Payment Amount | 105089.31 |
| Total Medical Medicare Standardized Payment Amount | 109392.74 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 657 |
| Number Of Beneficiaries Age 65 to 74 | 1155 |
| Number Of Beneficiaries Age 75 to 84 | 877 |
| Number Of Beneficiaries Age Greater 84 | 497 |
| Number Of Female Beneficiaries | 1727 |
| Number Of Male Beneficiaries | 1459 |
| Number Of Non Hispanic White Beneficiaries | 2641 |
| Number Of Black or African American Beneficiaries | 410 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 95 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2329 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 857 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.9793 |