| National Provider Identifier [NPI]: | 1558355750 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | DARSHAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 139 HAZARD AVE |
| Street Address 2 Of The Provider | BLDG 4, SUITE # 14 |
| City Of The Provider | ENFIELD |
| Zip Code Of The Provider | 060824585 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 3435 |
| Number Of Medicare Beneficiaries | 821 |
| Total Submitted Charge Amount | 393545.16 |
| Total Medicare Allowed Amount | 233379.62 |
| Total Medicare Payment Amount | 167496.4 |
| Total Medicare Standardized Payment Amount | 156600.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 331 |
| Number Of Medicare Beneficiaries With Drug Services | 153 |
| Total Drug Submitted ChargeAmount | 5540 |
| Total Drug Medicare AllowedAmount | 2719.25 |
| Total Drug Medicare PaymentAmount | 2512.05 |
| Total Drug Medicare Standardized Payment Amount | 2512.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 3104 |
| Number Of Medicare Beneficiaries With Medical Services | 821 |
| Total Medical Submitted Charge Amount | 388005.16 |
| Total Medical Medicare Allowed Amount | 230660.37 |
| Total Medical Medicare Payment Amount | 164984.35 |
| Total Medical Medicare Standardized Payment Amount | 154088.35 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 100 |
| Number Of Beneficiaries Age 65 to 74 | 197 |
| Number Of Beneficiaries Age 75 to 84 | 256 |
| Number Of Beneficiaries Age Greater 84 | 268 |
| Number Of Female Beneficiaries | 520 |
| Number Of Male Beneficiaries | 301 |
| Number Of Non Hispanic White Beneficiaries | 771 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 484 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 337 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5416 |