National Provider Identifier [NPI]: |
1013141621 |
Last Name Of The Provider |
SWIFT |
First Name Of The Provider |
SHANNON |
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 |
3443 HARRISON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BATESVILLE |
Zip Code Of The Provider |
725018820 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
2190 |
Number Of Medicare Beneficiaries |
380 |
Total Submitted Charge Amount |
143998 |
Total Medicare Allowed Amount |
129130.07 |
Total Medicare Payment Amount |
95256.36 |
Total Medicare Standardized Payment Amount |
91307.42 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
73 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
1132 |
Total Drug Medicare AllowedAmount |
876.63 |
Total Drug Medicare PaymentAmount |
836.1 |
Total Drug Medicare Standardized Payment Amount |
836.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
67 |
Number Of Medical Services |
2117 |
Number Of Medicare Beneficiaries With Medical Services |
380 |
Total Medical Submitted Charge Amount |
142866 |
Total Medical Medicare Allowed Amount |
128253.44 |
Total Medical Medicare Payment Amount |
94420.26 |
Total Medical Medicare Standardized Payment Amount |
90471.32 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
113 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
74 |
Number Of Female Beneficiaries |
228 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
365 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
216 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
164 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.8342 |