National Provider Identifier [NPI]: |
1780622092 |
Last Name Of The Provider |
SHELTON |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3600 GASTON AVE |
Street Address 2 Of The Provider |
SUITE 851 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752461800 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
1867 |
Number Of Medicare Beneficiaries |
419 |
Total Submitted Charge Amount |
186955.37 |
Total Medicare Allowed Amount |
172606.23 |
Total Medicare Payment Amount |
129479.56 |
Total Medicare Standardized Payment Amount |
129651.84 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
380 |
Number Of Medicare Beneficiaries With Drug Services |
93 |
Total Drug Submitted ChargeAmount |
21236.84 |
Total Drug Medicare AllowedAmount |
20128.3 |
Total Drug Medicare PaymentAmount |
15347.66 |
Total Drug Medicare Standardized Payment Amount |
15347.66 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
1487 |
Number Of Medicare Beneficiaries With Medical Services |
419 |
Total Medical Submitted Charge Amount |
165718.53 |
Total Medical Medicare Allowed Amount |
152477.93 |
Total Medical Medicare Payment Amount |
114131.9 |
Total Medical Medicare Standardized Payment Amount |
114304.18 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
137 |
Number Of Beneficiaries Age 75 to 84 |
170 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
250 |
Number Of Non Hispanic White Beneficiaries |
314 |
Number Of Black or African American Beneficiaries |
75 |
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 |
366 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
74 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4986 |