| National Provider Identifier [NPI]: | 1386646420 |
| Last Name Of The Provider | SHOR |
| First Name Of The Provider | ROBERT |
| 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 | 1860 TOWN CENTER DR |
| Street Address 2 Of The Provider | STE 120 |
| City Of The Provider | RESTON |
| Zip Code Of The Provider | 201905898 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 2545 |
| Number Of Medicare Beneficiaries | 1162 |
| Total Submitted Charge Amount | 523933 |
| Total Medicare Allowed Amount | 264016.23 |
| Total Medicare Payment Amount | 189882.08 |
| Total Medicare Standardized Payment Amount | 170922.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 2545 |
| Number Of Medicare Beneficiaries With Medical Services | 1162 |
| Total Medical Submitted Charge Amount | 523933 |
| Total Medical Medicare Allowed Amount | 264016.23 |
| Total Medical Medicare Payment Amount | 189882.08 |
| Total Medical Medicare Standardized Payment Amount | 170922.56 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 478 |
| Number Of Beneficiaries Age 75 to 84 | 396 |
| Number Of Beneficiaries Age Greater 84 | 241 |
| Number Of Female Beneficiaries | 586 |
| Number Of Male Beneficiaries | 576 |
| Number Of Non Hispanic White Beneficiaries | 945 |
| Number Of Black or African American Beneficiaries | 68 |
| Number Of AsianPacific Islander Beneficiaries | 72 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1028 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 134 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.4489 |