| National Provider Identifier [NPI]: | 1245204239 |
| Last Name Of The Provider | SHUFFELTON |
| First Name Of The Provider | VICTORIA |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10862 CALLE VERDE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LA MESA |
| Zip Code Of The Provider | 919417338 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 523 |
| Number Of Medicare Beneficiaries | 182 |
| Total Submitted Charge Amount | 79461.58 |
| Total Medicare Allowed Amount | 41277.06 |
| Total Medicare Payment Amount | 29741.57 |
| Total Medicare Standardized Payment Amount | 28556.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 57 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 3503.58 |
| Total Drug Medicare AllowedAmount | 1689.02 |
| Total Drug Medicare PaymentAmount | 1649.68 |
| Total Drug Medicare Standardized Payment Amount | 1649.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 466 |
| Number Of Medicare Beneficiaries With Medical Services | 182 |
| Total Medical Submitted Charge Amount | 75958 |
| Total Medical Medicare Allowed Amount | 39588.04 |
| Total Medical Medicare Payment Amount | 28091.89 |
| Total Medical Medicare Standardized Payment Amount | 26906.69 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 81 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 136 |
| Number Of Male Beneficiaries | 46 |
| Number Of Non Hispanic White Beneficiaries | 154 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 157 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8985 |