| National Provider Identifier [NPI]: | 1740244011 |
| Last Name Of The Provider | SHOOK |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 222 15TH AVE SE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PUYALLUP |
| Zip Code Of The Provider | 983723754 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 143 |
| Number Of Services | 7662 |
| Number Of Medicare Beneficiaries | 2377 |
| Total Submitted Charge Amount | 448932 |
| Total Medicare Allowed Amount | 135655.02 |
| Total Medicare Payment Amount | 102340.18 |
| Total Medicare Standardized Payment Amount | 102824.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 4421 |
| Number Of Medicare Beneficiaries With Drug Services | 58 |
| Total Drug Submitted ChargeAmount | 8902 |
| Total Drug Medicare AllowedAmount | 966.7 |
| Total Drug Medicare PaymentAmount | 757.78 |
| Total Drug Medicare Standardized Payment Amount | 757.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 139 |
| Number Of Medical Services | 3241 |
| Number Of Medicare Beneficiaries With Medical Services | 2377 |
| Total Medical Submitted Charge Amount | 440030 |
| Total Medical Medicare Allowed Amount | 134688.32 |
| Total Medical Medicare Payment Amount | 101582.4 |
| Total Medical Medicare Standardized Payment Amount | 102066.92 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 378 |
| Number Of Beneficiaries Age 65 to 74 | 862 |
| Number Of Beneficiaries Age 75 to 84 | 705 |
| Number Of Beneficiaries Age Greater 84 | 432 |
| Number Of Female Beneficiaries | 1492 |
| Number Of Male Beneficiaries | 885 |
| Number Of Non Hispanic White Beneficiaries | 2137 |
| Number Of Black or African American Beneficiaries | 89 |
| Number Of AsianPacific Islander Beneficiaries | 57 |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | 20 |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1890 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 487 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5604 |