National Provider Identifier [NPI]: |
1366513707 |
Last Name Of The Provider |
SHEA |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2485 HIGH SCHOOL AVE |
Street Address 2 Of The Provider |
SUITE214 |
City Of The Provider |
CONCORD |
Zip Code Of The Provider |
945201819 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
3785 |
Number Of Medicare Beneficiaries |
542 |
Total Submitted Charge Amount |
506276 |
Total Medicare Allowed Amount |
257345.08 |
Total Medicare Payment Amount |
191973.18 |
Total Medicare Standardized Payment Amount |
169188.89 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
284 |
Number Of Medicare Beneficiaries With Drug Services |
84 |
Total Drug Submitted ChargeAmount |
5185 |
Total Drug Medicare AllowedAmount |
169.83 |
Total Drug Medicare PaymentAmount |
126.81 |
Total Drug Medicare Standardized Payment Amount |
126.81 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
67 |
Number Of Medical Services |
3501 |
Number Of Medicare Beneficiaries With Medical Services |
542 |
Total Medical Submitted Charge Amount |
501091 |
Total Medical Medicare Allowed Amount |
257175.25 |
Total Medical Medicare Payment Amount |
191846.37 |
Total Medical Medicare Standardized Payment Amount |
169062.08 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
181 |
Number Of Beneficiaries Age 75 to 84 |
165 |
Number Of Beneficiaries Age Greater 84 |
134 |
Number Of Female Beneficiaries |
310 |
Number Of Male Beneficiaries |
232 |
Number Of Non Hispanic White Beneficiaries |
449 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
18 |
Number Of Hispanic Beneficiaries |
50 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
431 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
111 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.8767 |