National Provider Identifier [NPI]: |
1972503332 |
Last Name Of The Provider |
MCSHEA |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1200 VILLAGE HARBOR DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAKE WYLIE |
Zip Code Of The Provider |
297109092 |
State Code Of The Provider |
SC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
1678 |
Number Of Medicare Beneficiaries |
459 |
Total Submitted Charge Amount |
270557 |
Total Medicare Allowed Amount |
106028.29 |
Total Medicare Payment Amount |
68274.85 |
Total Medicare Standardized Payment Amount |
74805.84 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
151 |
Number Of Medicare Beneficiaries With Drug Services |
100 |
Total Drug Submitted ChargeAmount |
3826 |
Total Drug Medicare AllowedAmount |
1865.61 |
Total Drug Medicare PaymentAmount |
1803.25 |
Total Drug Medicare Standardized Payment Amount |
1803.25 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
1527 |
Number Of Medicare Beneficiaries With Medical Services |
459 |
Total Medical Submitted Charge Amount |
266731 |
Total Medical Medicare Allowed Amount |
104162.68 |
Total Medical Medicare Payment Amount |
66471.6 |
Total Medical Medicare Standardized Payment Amount |
73002.59 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
269 |
Number Of Beneficiaries Age 75 to 84 |
111 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
252 |
Number Of Male Beneficiaries |
207 |
Number Of Non Hispanic White Beneficiaries |
432 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
440 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.7585 |