| National Provider Identifier [NPI]: | 1396909255 |
| Last Name Of The Provider | SHABA |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3024 BUSINESS PARK CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | GOODLETTSVILLE |
| Zip Code Of The Provider | 370723132 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 189 |
| Number Of Services | 11655 |
| Number Of Medicare Beneficiaries | 3865 |
| Total Submitted Charge Amount | 1453835.97 |
| Total Medicare Allowed Amount | 261147.68 |
| Total Medicare Payment Amount | 197997.7 |
| Total Medicare Standardized Payment Amount | 217742.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 5437 |
| Number Of Medicare Beneficiaries With Drug Services | 57 |
| Total Drug Submitted ChargeAmount | 1037.75 |
| Total Drug Medicare AllowedAmount | 1029.51 |
| Total Drug Medicare PaymentAmount | 787.62 |
| Total Drug Medicare Standardized Payment Amount | 787.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 185 |
| Number Of Medical Services | 6218 |
| Number Of Medicare Beneficiaries With Medical Services | 3865 |
| Total Medical Submitted Charge Amount | 1452798.22 |
| Total Medical Medicare Allowed Amount | 260118.17 |
| Total Medical Medicare Payment Amount | 197210.08 |
| Total Medical Medicare Standardized Payment Amount | 216954.65 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 743 |
| Number Of Beneficiaries Age 65 to 74 | 1470 |
| Number Of Beneficiaries Age 75 to 84 | 1093 |
| Number Of Beneficiaries Age Greater 84 | 559 |
| Number Of Female Beneficiaries | 2288 |
| Number Of Male Beneficiaries | 1577 |
| Number Of Non Hispanic White Beneficiaries | 3329 |
| Number Of Black or African American Beneficiaries | 449 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3030 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 835 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6782 |