| National Provider Identifier [NPI]: | 1467646604 |
| Last Name Of The Provider | SHAW |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 190 N EVERGREEN AVE |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | WOODBURY |
| Zip Code Of The Provider | 080961862 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 3802 |
| Number Of Medicare Beneficiaries | 712 |
| Total Submitted Charge Amount | 250336 |
| Total Medicare Allowed Amount | 220266.98 |
| Total Medicare Payment Amount | 159954.42 |
| Total Medicare Standardized Payment Amount | 144441.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 269 |
| Number Of Medicare Beneficiaries With Drug Services | 220 |
| Total Drug Submitted ChargeAmount | 6275 |
| Total Drug Medicare AllowedAmount | 3587.92 |
| Total Drug Medicare PaymentAmount | 3507 |
| Total Drug Medicare Standardized Payment Amount | 3507 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 3533 |
| Number Of Medicare Beneficiaries With Medical Services | 712 |
| Total Medical Submitted Charge Amount | 244061 |
| Total Medical Medicare Allowed Amount | 216679.06 |
| Total Medical Medicare Payment Amount | 156447.42 |
| Total Medical Medicare Standardized Payment Amount | 140934.09 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 224 |
| Number Of Beneficiaries Age 75 to 84 | 257 |
| Number Of Beneficiaries Age Greater 84 | 169 |
| Number Of Female Beneficiaries | 409 |
| Number Of Male Beneficiaries | 303 |
| Number Of Non Hispanic White Beneficiaries | 660 |
| Number Of Black or African American Beneficiaries | 35 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 659 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2363 |