| National Provider Identifier [NPI]: | 1952367930 |
| Last Name Of The Provider | SHERIDAN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 212 LE PHILLIP CT |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | CONCORD |
| Zip Code Of The Provider | 280252984 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 244 |
| Number Of Services | 5522 |
| Number Of Medicare Beneficiaries | 3823 |
| Total Submitted Charge Amount | 903474 |
| Total Medicare Allowed Amount | 184006.8 |
| Total Medicare Payment Amount | 142844.36 |
| Total Medicare Standardized Payment Amount | 148947.54 |
| 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 | 244 |
| Number Of Medical Services | 5522 |
| Number Of Medicare Beneficiaries With Medical Services | 3823 |
| Total Medical Submitted Charge Amount | 903474 |
| Total Medical Medicare Allowed Amount | 184006.8 |
| Total Medical Medicare Payment Amount | 142844.36 |
| Total Medical Medicare Standardized Payment Amount | 148947.54 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 932 |
| Number Of Beneficiaries Age 65 to 74 | 1377 |
| Number Of Beneficiaries Age 75 to 84 | 1003 |
| Number Of Beneficiaries Age Greater 84 | 511 |
| Number Of Female Beneficiaries | 2172 |
| Number Of Male Beneficiaries | 1651 |
| Number Of Non Hispanic White Beneficiaries | 2721 |
| Number Of Black or African American Beneficiaries | 942 |
| Number Of AsianPacific Islander Beneficiaries | 48 |
| Number Of Hispanic Beneficiaries | 69 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2574 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1249 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.0757 |