National Provider Identifier [NPI]: |
1386644250 |
Last Name Of The Provider |
SHEEHY |
First Name Of The Provider |
KERRY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1875 WOODWINDS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
WOODBURY |
Zip Code Of The Provider |
551252298 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
175 |
Number Of Medicare Beneficiaries |
43 |
Total Submitted Charge Amount |
16379 |
Total Medicare Allowed Amount |
7566.51 |
Total Medicare Payment Amount |
5512.37 |
Total Medicare Standardized Payment Amount |
5674.27 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
25 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
762 |
Total Drug Medicare AllowedAmount |
583.7 |
Total Drug Medicare PaymentAmount |
571.17 |
Total Drug Medicare Standardized Payment Amount |
571.17 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
150 |
Number Of Medicare Beneficiaries With Medical Services |
43 |
Total Medical Submitted Charge Amount |
15617 |
Total Medical Medicare Allowed Amount |
6982.81 |
Total Medical Medicare Payment Amount |
4941.2 |
Total Medical Medicare Standardized Payment Amount |
5103.1 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
19 |
Number Of Beneficiaries Age 75 to 84 |
12 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
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Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
35 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8928 |