| National Provider Identifier [NPI]: | 1720042070 |
| Last Name Of The Provider | SHAHIN |
| First Name Of The Provider | ISLAM |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1750 N HAMPTON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DESOTO |
| Zip Code Of The Provider | 751152306 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 185 |
| Number Of Services | 2974 |
| Number Of Medicare Beneficiaries | 623 |
| Total Submitted Charge Amount | 1393630.42 |
| Total Medicare Allowed Amount | 281418.84 |
| Total Medicare Payment Amount | 217212.72 |
| Total Medicare Standardized Payment Amount | 217821.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 607 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 1964.06 |
| Total Drug Medicare AllowedAmount | 244.28 |
| Total Drug Medicare PaymentAmount | 179.42 |
| Total Drug Medicare Standardized Payment Amount | 179.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 176 |
| Number Of Medical Services | 2367 |
| Number Of Medicare Beneficiaries With Medical Services | 623 |
| Total Medical Submitted Charge Amount | 1391666.36 |
| Total Medical Medicare Allowed Amount | 281174.56 |
| Total Medical Medicare Payment Amount | 217033.3 |
| Total Medical Medicare Standardized Payment Amount | 217642.46 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 221 |
| Number Of Beneficiaries Age 65 to 74 | 229 |
| Number Of Beneficiaries Age 75 to 84 | 126 |
| Number Of Beneficiaries Age Greater 84 | 47 |
| Number Of Female Beneficiaries | 328 |
| Number Of Male Beneficiaries | 295 |
| Number Of Non Hispanic White Beneficiaries | 235 |
| Number Of Black or African American Beneficiaries | 271 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 100 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 333 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 290 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 56 |
| Percent Of With Chronic Kidney Disease | 72 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 65 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 4.3098 |