National Provider Identifier [NPI]: |
1629109764 |
Last Name Of The Provider |
SHIELDS |
First Name Of The Provider |
EMILY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16000 JOHNSTON MEMORIAL DR |
Street Address 2 Of The Provider |
SUITE 312 |
City Of The Provider |
ABINGDON |
Zip Code Of The Provider |
242117664 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
6735 |
Number Of Medicare Beneficiaries |
741 |
Total Submitted Charge Amount |
414647 |
Total Medicare Allowed Amount |
189238.55 |
Total Medicare Payment Amount |
137760.87 |
Total Medicare Standardized Payment Amount |
141487.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
5292 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
42420 |
Total Drug Medicare AllowedAmount |
28934.74 |
Total Drug Medicare PaymentAmount |
22679.45 |
Total Drug Medicare Standardized Payment Amount |
22679.45 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
1443 |
Number Of Medicare Beneficiaries With Medical Services |
741 |
Total Medical Submitted Charge Amount |
372227 |
Total Medical Medicare Allowed Amount |
160303.81 |
Total Medical Medicare Payment Amount |
115081.42 |
Total Medical Medicare Standardized Payment Amount |
118807.92 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
217 |
Number Of Beneficiaries Age 65 to 74 |
241 |
Number Of Beneficiaries Age 75 to 84 |
207 |
Number Of Beneficiaries Age Greater 84 |
76 |
Number Of Female Beneficiaries |
434 |
Number Of Male Beneficiaries |
307 |
Number Of Non Hispanic White Beneficiaries |
724 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
503 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
238 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
26 |
Average HCC Risk Score Of Beneficiaries |
1.4488 |