National Provider Identifier [NPI]: |
1467581348 |
Last Name Of The Provider |
SHELTON |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4525 CAMERON VALLEY PKWY |
Street Address 2 Of The Provider |
SUITE 3100 |
City Of The Provider |
CHARLOTTE |
Zip Code Of The Provider |
282114369 |
State Code Of The Provider |
NC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
75 |
Number Of Services |
3218 |
Number Of Medicare Beneficiaries |
258 |
Total Submitted Charge Amount |
276342 |
Total Medicare Allowed Amount |
119142.39 |
Total Medicare Payment Amount |
93549.41 |
Total Medicare Standardized Payment Amount |
98702.58 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
119 |
Number Of Medicare Beneficiaries With Drug Services |
97 |
Total Drug Submitted ChargeAmount |
8299 |
Total Drug Medicare AllowedAmount |
3497.23 |
Total Drug Medicare PaymentAmount |
3266.85 |
Total Drug Medicare Standardized Payment Amount |
3266.85 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
65 |
Number Of Medical Services |
3099 |
Number Of Medicare Beneficiaries With Medical Services |
258 |
Total Medical Submitted Charge Amount |
268043 |
Total Medical Medicare Allowed Amount |
115645.16 |
Total Medical Medicare Payment Amount |
90282.56 |
Total Medical Medicare Standardized Payment Amount |
95435.73 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
89 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
125 |
Number Of Male Beneficiaries |
133 |
Number Of Non Hispanic White Beneficiaries |
220 |
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 |
247 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9455 |