| National Provider Identifier [NPI]: | 1346287315 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | HETAL |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5999 NEW WILKE RD |
| Street Address 2 Of The Provider | SUITE 200, BLDG 2 |
| City Of The Provider | ROLLING MEADOWS |
| Zip Code Of The Provider | 600084506 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 2774 |
| Number Of Medicare Beneficiaries | 678 |
| Total Submitted Charge Amount | 312750 |
| Total Medicare Allowed Amount | 182739.41 |
| Total Medicare Payment Amount | 136925.53 |
| Total Medicare Standardized Payment Amount | 128602.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 365 |
| Number Of Medicare Beneficiaries With Drug Services | 101 |
| Total Drug Submitted ChargeAmount | 12300 |
| Total Drug Medicare AllowedAmount | 4848.59 |
| Total Drug Medicare PaymentAmount | 4166.24 |
| Total Drug Medicare Standardized Payment Amount | 4166.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 2409 |
| Number Of Medicare Beneficiaries With Medical Services | 678 |
| Total Medical Submitted Charge Amount | 300450 |
| Total Medical Medicare Allowed Amount | 177890.82 |
| Total Medical Medicare Payment Amount | 132759.29 |
| Total Medical Medicare Standardized Payment Amount | 124436.72 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 237 |
| Number Of Beneficiaries Age 75 to 84 | 272 |
| Number Of Beneficiaries Age Greater 84 | 146 |
| Number Of Female Beneficiaries | 477 |
| Number Of Male Beneficiaries | 201 |
| Number Of Non Hispanic White Beneficiaries | 655 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 652 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2757 |