National Provider Identifier [NPI]: |
1407818263 |
Last Name Of The Provider |
SHEPERD |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
888 S KING ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
HONOLULU |
Zip Code Of The Provider |
968133097 |
State Code Of The Provider |
HI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
214 |
Number Of Services |
5925 |
Number Of Medicare Beneficiaries |
3034 |
Total Submitted Charge Amount |
473296.33 |
Total Medicare Allowed Amount |
140224.43 |
Total Medicare Payment Amount |
103628.7 |
Total Medicare Standardized Payment Amount |
106730.33 |
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 |
214 |
Number Of Medical Services |
5925 |
Number Of Medicare Beneficiaries With Medical Services |
3034 |
Total Medical Submitted Charge Amount |
473296.33 |
Total Medical Medicare Allowed Amount |
140224.43 |
Total Medical Medicare Payment Amount |
103628.7 |
Total Medical Medicare Standardized Payment Amount |
106730.33 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
241 |
Number Of Beneficiaries Age 65 to 74 |
1194 |
Number Of Beneficiaries Age 75 to 84 |
958 |
Number Of Beneficiaries Age Greater 84 |
641 |
Number Of Female Beneficiaries |
1821 |
Number Of Male Beneficiaries |
1213 |
Number Of Non Hispanic White Beneficiaries |
993 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
1541 |
Number Of Hispanic Beneficiaries |
127 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
338 |
Number Of Beneficiaries With Medicare Only Entitlement |
2730 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
304 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3474 |