| National Provider Identifier [NPI]: | 1316193907 |
| Last Name Of The Provider | SHAH |
| First Name Of The Provider | KOONJ |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1305 W 34TH ST |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787051923 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 1769 |
| Number Of Medicare Beneficiaries | 529 |
| Total Submitted Charge Amount | 455385 |
| Total Medicare Allowed Amount | 219517.03 |
| Total Medicare Payment Amount | 170770.23 |
| Total Medicare Standardized Payment Amount | 171052.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 18 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 553 |
| Total Drug Medicare AllowedAmount | 552.96 |
| Total Drug Medicare PaymentAmount | 541.9 |
| Total Drug Medicare Standardized Payment Amount | 541.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 1751 |
| Number Of Medicare Beneficiaries With Medical Services | 529 |
| Total Medical Submitted Charge Amount | 454832 |
| Total Medical Medicare Allowed Amount | 218964.07 |
| Total Medical Medicare Payment Amount | 170228.33 |
| Total Medical Medicare Standardized Payment Amount | 170510.5 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 107 |
| Number Of Beneficiaries Age 65 to 74 | 190 |
| Number Of Beneficiaries Age 75 to 84 | 150 |
| Number Of Beneficiaries Age Greater 84 | 82 |
| Number Of Female Beneficiaries | 248 |
| Number Of Male Beneficiaries | 281 |
| Number Of Non Hispanic White Beneficiaries | 354 |
| Number Of Black or African American Beneficiaries | 82 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 77 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 379 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 150 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 61 |
| Percent Of With Chronic Kidney Disease | 62 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 47 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.4506 |