| National Provider Identifier [NPI]: | 1972766368 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | TINA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 S WHITING ST STE 105 |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALEXANDRIA |
| Zip Code Of The Provider | 223043416 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 1151 |
| Number Of Medicare Beneficiaries | 183 |
| Total Submitted Charge Amount | 98218.26 |
| Total Medicare Allowed Amount | 52550.78 |
| Total Medicare Payment Amount | 37180.45 |
| Total Medicare Standardized Payment Amount | 34930.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 672 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 10901.39 |
| Total Drug Medicare AllowedAmount | 6749.21 |
| Total Drug Medicare PaymentAmount | 5287.79 |
| Total Drug Medicare Standardized Payment Amount | 5287.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 479 |
| Number Of Medicare Beneficiaries With Medical Services | 183 |
| Total Medical Submitted Charge Amount | 87316.87 |
| Total Medical Medicare Allowed Amount | 45801.57 |
| Total Medical Medicare Payment Amount | 31892.66 |
| Total Medical Medicare Standardized Payment Amount | 29642.94 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 68 |
| Number Of Beneficiaries Age 75 to 84 | 45 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 130 |
| Number Of Male Beneficiaries | 53 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 97 |
| 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 | 115 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 68 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7232 |