| National Provider Identifier [NPI]: | 1669454500 |
| Last Name Of The Provider | SHAW |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11155 DUNN RD |
| Street Address 2 Of The Provider | SUITE 205E |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631366150 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 3475 |
| Number Of Medicare Beneficiaries | 528 |
| Total Submitted Charge Amount | 289621 |
| Total Medicare Allowed Amount | 149662.21 |
| Total Medicare Payment Amount | 106965.69 |
| Total Medicare Standardized Payment Amount | 105949.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 166 |
| Number Of Medicare Beneficiaries With Drug Services | 138 |
| Total Drug Submitted ChargeAmount | 7556 |
| Total Drug Medicare AllowedAmount | 2866.67 |
| Total Drug Medicare PaymentAmount | 2779.1 |
| Total Drug Medicare Standardized Payment Amount | 2779.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 3309 |
| Number Of Medicare Beneficiaries With Medical Services | 527 |
| Total Medical Submitted Charge Amount | 282065 |
| Total Medical Medicare Allowed Amount | 146795.54 |
| Total Medical Medicare Payment Amount | 104186.59 |
| Total Medical Medicare Standardized Payment Amount | 103170.3 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 196 |
| Number Of Beneficiaries Age 75 to 84 | 156 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 274 |
| Number Of Male Beneficiaries | 254 |
| Number Of Non Hispanic White Beneficiaries | 427 |
| Number Of Black or African American Beneficiaries | |
| 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 | 468 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 60 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3467 |