National Provider Identifier [NPI]: |
1962440271 |
Last Name Of The Provider |
SHEA |
First Name Of The Provider |
BARRY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
593 EDDY ST |
Street Address 2 Of The Provider |
APC 7 |
City Of The Provider |
PROVIDENCE |
Zip Code Of The Provider |
029034923 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
379 |
Number Of Medicare Beneficiaries |
165 |
Total Submitted Charge Amount |
93517.2 |
Total Medicare Allowed Amount |
28650.81 |
Total Medicare Payment Amount |
21993.55 |
Total Medicare Standardized Payment Amount |
21462.67 |
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 |
25 |
Number Of Medical Services |
379 |
Number Of Medicare Beneficiaries With Medical Services |
165 |
Total Medical Submitted Charge Amount |
93517.2 |
Total Medical Medicare Allowed Amount |
28650.81 |
Total Medical Medicare Payment Amount |
21993.55 |
Total Medical Medicare Standardized Payment Amount |
21462.67 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
92 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
139 |
Number Of Black or African American Beneficiaries |
|
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 |
117 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
55 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.7024 |