National Provider Identifier [NPI]: |
1093988008 |
Last Name Of The Provider |
SHIRES |
First Name Of The Provider |
JAY |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
294 SUMMAR DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
383013915 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
3082 |
Number Of Medicare Beneficiaries |
1038 |
Total Submitted Charge Amount |
701159.48 |
Total Medicare Allowed Amount |
293783.36 |
Total Medicare Payment Amount |
228191.15 |
Total Medicare Standardized Payment Amount |
241125.13 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
268 |
Number Of Beneficiaries Age 65 to 74 |
335 |
Number Of Beneficiaries Age 75 to 84 |
266 |
Number Of Beneficiaries Age Greater 84 |
169 |
Number Of Female Beneficiaries |
552 |
Number Of Male Beneficiaries |
486 |
Number Of Non Hispanic White Beneficiaries |
830 |
Number Of Black or African American Beneficiaries |
195 |
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 |
561 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
477 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.3833 |