National Provider Identifier [NPI]: |
1235354010 |
Last Name Of The Provider |
SHAW |
First Name Of The Provider |
KATHRYN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 HOSPITAL DR |
Street Address 2 Of The Provider |
DEPARTMENT OF EMERGENCY MEDICINE |
City Of The Provider |
MONROE |
Zip Code Of The Provider |
281126000 |
State Code Of The Provider |
NC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
435 |
Number Of Medicare Beneficiaries |
383 |
Total Submitted Charge Amount |
367595.5 |
Total Medicare Allowed Amount |
56353.21 |
Total Medicare Payment Amount |
42442.66 |
Total Medicare Standardized Payment Amount |
43872.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
435 |
Number Of Medicare Beneficiaries With Medical Services |
383 |
Total Medical Submitted Charge Amount |
367595.5 |
Total Medical Medicare Allowed Amount |
56353.21 |
Total Medical Medicare Payment Amount |
42442.66 |
Total Medical Medicare Standardized Payment Amount |
43872.6 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
115 |
Number Of Beneficiaries Age 65 to 74 |
130 |
Number Of Beneficiaries Age 75 to 84 |
96 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
213 |
Number Of Male Beneficiaries |
170 |
Number Of Non Hispanic White Beneficiaries |
301 |
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 |
241 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
142 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.0394 |