National Provider Identifier [NPI]: |
1013933233 |
Last Name Of The Provider |
SHIFREN |
First Name Of The Provider |
ADRIAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4921 PARKVIEW PL |
Street Address 2 Of The Provider |
8TH FLOOR |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631101032 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
770 |
Number Of Medicare Beneficiaries |
376 |
Total Submitted Charge Amount |
162047 |
Total Medicare Allowed Amount |
64519.02 |
Total Medicare Payment Amount |
49082.84 |
Total Medicare Standardized Payment Amount |
50438.51 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
23 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
1154 |
Total Drug Medicare AllowedAmount |
728.9 |
Total Drug Medicare PaymentAmount |
637.98 |
Total Drug Medicare Standardized Payment Amount |
637.98 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
747 |
Number Of Medicare Beneficiaries With Medical Services |
376 |
Total Medical Submitted Charge Amount |
160893 |
Total Medical Medicare Allowed Amount |
63790.12 |
Total Medical Medicare Payment Amount |
48444.86 |
Total Medical Medicare Standardized Payment Amount |
49800.53 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
144 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
214 |
Number Of Male Beneficiaries |
162 |
Number Of Non Hispanic White Beneficiaries |
284 |
Number Of Black or African American Beneficiaries |
80 |
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 |
253 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
123 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
59 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.4025 |