National Provider Identifier [NPI]: |
1972595437 |
Last Name Of The Provider |
SHKEDY |
First Name Of The Provider |
CLIVE |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16675 TOWN CENTER BLVD. |
Street Address 2 Of The Provider |
SUITE 150 |
City Of The Provider |
SUGAR LAND |
Zip Code Of The Provider |
77479 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
2431 |
Number Of Medicare Beneficiaries |
236 |
Total Submitted Charge Amount |
649270 |
Total Medicare Allowed Amount |
210593.43 |
Total Medicare Payment Amount |
161365.9 |
Total Medicare Standardized Payment Amount |
157313.04 |
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 |
37 |
Number Of Medical Services |
2431 |
Number Of Medicare Beneficiaries With Medical Services |
236 |
Total Medical Submitted Charge Amount |
649270 |
Total Medical Medicare Allowed Amount |
210593.43 |
Total Medical Medicare Payment Amount |
161365.9 |
Total Medical Medicare Standardized Payment Amount |
157313.04 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
144 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
170 |
Number Of Black or African American Beneficiaries |
34 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
206 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
70 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.7171 |