| National Provider Identifier [NPI]: | 1457420903 |
| Last Name Of The Provider | SHAHANE |
| First Name Of The Provider | RAVINDRANATH |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1734 N RIVERSIDE AVE |
| Street Address 2 Of The Provider | SUITE #2 |
| City Of The Provider | RIALTO |
| Zip Code Of The Provider | 923768058 |
| 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 | 31 |
| Number Of Services | 2810 |
| Number Of Medicare Beneficiaries | 231 |
| Total Submitted Charge Amount | 398255 |
| Total Medicare Allowed Amount | 233516.24 |
| Total Medicare Payment Amount | 172203.12 |
| Total Medicare Standardized Payment Amount | 166631.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 128 |
| Number Of Medicare Beneficiaries With Drug Services | 89 |
| Total Drug Submitted ChargeAmount | 5330 |
| Total Drug Medicare AllowedAmount | 1798.23 |
| Total Drug Medicare PaymentAmount | 1744.31 |
| Total Drug Medicare Standardized Payment Amount | 1744.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 2682 |
| Number Of Medicare Beneficiaries With Medical Services | 231 |
| Total Medical Submitted Charge Amount | 392925 |
| Total Medical Medicare Allowed Amount | 231718.01 |
| Total Medical Medicare Payment Amount | 170458.81 |
| Total Medical Medicare Standardized Payment Amount | 164887.27 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 81 |
| Number Of Beneficiaries Age 65 to 74 | 80 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 122 |
| Number Of Male Beneficiaries | 109 |
| Number Of Non Hispanic White Beneficiaries | 72 |
| Number Of Black or African American Beneficiaries | 64 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 73 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 39 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 192 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 74 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.0178 |