| National Provider Identifier [NPI]: | 1114935715 |
| Last Name Of The Provider | SHORT |
| First Name Of The Provider | TERRY |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 832 PRINCETON AVE SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 352111320 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 154 |
| Number Of Services | 7716 |
| Number Of Medicare Beneficiaries | 498 |
| Total Submitted Charge Amount | 296791 |
| Total Medicare Allowed Amount | 200079.59 |
| Total Medicare Payment Amount | 149570.89 |
| Total Medicare Standardized Payment Amount | 155027.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 23 |
| Number Of Drug Services | 2703 |
| Number Of Medicare Beneficiaries With Drug Services | 141 |
| Total Drug Submitted ChargeAmount | 13394 |
| Total Drug Medicare AllowedAmount | 7580.72 |
| Total Drug Medicare PaymentAmount | 6413.43 |
| Total Drug Medicare Standardized Payment Amount | 6413.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 131 |
| Number Of Medical Services | 5013 |
| Number Of Medicare Beneficiaries With Medical Services | 498 |
| Total Medical Submitted Charge Amount | 283397 |
| Total Medical Medicare Allowed Amount | 192498.87 |
| Total Medical Medicare Payment Amount | 143157.46 |
| Total Medical Medicare Standardized Payment Amount | 148614.04 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 93 |
| Number Of Beneficiaries Age 65 to 74 | 169 |
| Number Of Beneficiaries Age 75 to 84 | 168 |
| Number Of Beneficiaries Age Greater 84 | 68 |
| Number Of Female Beneficiaries | 291 |
| Number Of Male Beneficiaries | 207 |
| Number Of Non Hispanic White Beneficiaries | 309 |
| 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 | 400 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 98 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4741 |