National Provider Identifier [NPI]: |
1225035694 |
Last Name Of The Provider |
SHEA |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
263 FARMINGTON AVE |
Street Address 2 Of The Provider |
ORTHOPEDICS |
City Of The Provider |
FARMINGTON |
Zip Code Of The Provider |
060300001 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
743 |
Number Of Medicare Beneficiaries |
247 |
Total Submitted Charge Amount |
348933 |
Total Medicare Allowed Amount |
98647.83 |
Total Medicare Payment Amount |
76040.99 |
Total Medicare Standardized Payment Amount |
70775.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
126 |
Number Of Medicare Beneficiaries With Drug Services |
38 |
Total Drug Submitted ChargeAmount |
2088 |
Total Drug Medicare AllowedAmount |
838.27 |
Total Drug Medicare PaymentAmount |
657.29 |
Total Drug Medicare Standardized Payment Amount |
657.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
617 |
Number Of Medicare Beneficiaries With Medical Services |
247 |
Total Medical Submitted Charge Amount |
346845 |
Total Medical Medicare Allowed Amount |
97809.56 |
Total Medical Medicare Payment Amount |
75383.7 |
Total Medical Medicare Standardized Payment Amount |
70118.33 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
111 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
138 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
212 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
183 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
64 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1234 |