| National Provider Identifier [NPI]: | 1548289630 |
| Last Name Of The Provider | SHUKLA |
| First Name Of The Provider | RAJEEV |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 845 S FAIRMONT AVE |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | LODI |
| Zip Code Of The Provider | 952405113 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 4413 |
| Number Of Medicare Beneficiaries | 468 |
| Total Submitted Charge Amount | 353525 |
| Total Medicare Allowed Amount | 238901.3 |
| Total Medicare Payment Amount | 171899.29 |
| Total Medicare Standardized Payment Amount | 168314.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 997 |
| Number Of Medicare Beneficiaries With Drug Services | 181 |
| Total Drug Submitted ChargeAmount | 16835 |
| Total Drug Medicare AllowedAmount | 3254.05 |
| Total Drug Medicare PaymentAmount | 2596.49 |
| Total Drug Medicare Standardized Payment Amount | 2596.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 3416 |
| Number Of Medicare Beneficiaries With Medical Services | 468 |
| Total Medical Submitted Charge Amount | 336690 |
| Total Medical Medicare Allowed Amount | 235647.25 |
| Total Medical Medicare Payment Amount | 169302.8 |
| Total Medical Medicare Standardized Payment Amount | 165717.78 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 232 |
| Number Of Beneficiaries Age 75 to 84 | 157 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 268 |
| Number Of Male Beneficiaries | 200 |
| Number Of Non Hispanic White Beneficiaries | 439 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 452 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 7 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.0152 |