Physician

Prakash D Shah, M.D.

According to 2025 Medicare claims, Prakash Shah, M.D. (NPI: 1013917996) practices cardiology in the Kenosha, WI market, with the plurality of this provider's patient population coming from Kenosha, WI. This provider's primary affiliated billing organization is AURORA MEDICAL GROUP, INC. (NPI: 1427271378; TIN: 391678306) and primary practice location at 53142-7884. Shah is affiliated with the Advocate Physician Partners Accountable Care, Inc. (ACO ID: A1033) and Accountable Care Organization of Advocate Aurora Health, LLC (ACO ID: D0260), participating under both the MSSP and REACH models.

Shah's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 3,976 traditional Medicare patients, billed 18,375 HCPCS/CPT codes, and received $379,180 in Medicare payments. The top billing code was 99213 (Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more). Part D data shows 33,995 prescription claims across 3,497 beneficiaries totaling $5,130,284 in drug costs, led by Xarelto (Rivaroxaban). 2023 DME data shows 21 claims. Open Payments data shows 20 records totaling $11,634. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has changed little. Concurrently, Part D prescription costs have moved sharply higher in recent years, from $1,230,843 to $5,130,284. In contrast, DME billing represents a smaller volume and fell sharply in recent years, from $19,250 to $9,053.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	3,505	13,154	$374,863
2016	3,821	14,280	$375,558
2017	3,849	14,156	$371,594
2018	3,884	13,692	$367,975
2019	3,930	14,423	$402,385
2020	3,848	12,756	$357,188
2021	3,898	12,089	$411,016
2022	3,799	11,710	$380,618
2023	4,065	12,775	$350,507
2024	3,976	18,375	$379,180

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	1,391	13,465	$1,230,843
2016	1,531	14,730	$1,454,897
2017	1,787	17,114	$1,821,269
2018	2,009	19,592	$2,251,579
2019	2,266	21,654	$2,369,560
2020	2,494	24,055	$2,889,381
2021	2,763	26,132	$3,338,575
2022	2,954	28,380	$3,994,431
2023	3,171	30,317	$4,728,061
2024	3,497	33,995	$5,130,284

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	N/R	16	$32,969
2018	N/R	N/R	N/R
2019	N/R	N/R	N/R
2020	N/R	11	$517
2021	N/R	N/R	N/R
2022	N/R	11	$316
2023	N/R	21	$53,792
2024	N/R	N/R	N/R

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	1,628	2,142	$58
78452	Nuclear medicine studies of heart muscle at rest and with stress and spect	338	338	$50
93306	Ultrasound of heart with color-depicted blood flow, rate, direction and valve function	519	521	$45
93016	Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician	323	323	$14
93010	Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	2,335	4,019	$6

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Xarelto	Rivaroxaban	1,950	130,409	$2,417,110
Entresto	Sacubitril/Valsartan	485	30,298	$625,979
Eliquis	Apixaban	487	27,945	$544,899
Repatha Sureclick	Evolocumab	390	23,250	$418,085
Ranolazine Er	Ranolazine	1,191	72,685	$136,200

Top 5 DME services in 2024

No connected or detailed DME service-level records for 2024.

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	20	$11,634	Janssen Pharmaceuticals, Inc
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for Prakash D. Shah, M.D.?

Tedicare shows public-source Medicare data for Prakash D. Shah, M.D. (NPI 1013917996), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Prakash D. Shah, M.D. have ACO affiliation data?

Prakash D. Shah, M.D. is shown with ACO affiliation data for Advocate Physician Partners Accountable Care, Inc. (MSSP, ACO ID A1033) and Accountable Care Organization of Advocate Aurora Health, LLC (REACH, ACO ID D0260).

What billing organization is linked to Prakash D. Shah, M.D.?

Prakash D. Shah, M.D. is linked to AURORA MEDICAL GROUP, INC. (billing NPI 1427271378) in the available physician profile data.

Does Prakash D. Shah, M.D. have Open Payments data?

Prakash D. Shah, M.D. has 20 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.