National Provider Identifier [NPI]: |
1417900754 |
Last Name Of The Provider |
SHEEHAN |
First Name Of The Provider |
MELISSA |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
405 SILVERSIDE RD |
Street Address 2 Of The Provider |
SUITE 111 |
City Of The Provider |
WILMINGTON |
Zip Code Of The Provider |
198091774 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
1058 |
Number Of Medicare Beneficiaries |
240 |
Total Submitted Charge Amount |
116652 |
Total Medicare Allowed Amount |
86495.74 |
Total Medicare Payment Amount |
59360.28 |
Total Medicare Standardized Payment Amount |
58632.02 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
88 |
Number Of Medicare Beneficiaries With Drug Services |
82 |
Total Drug Submitted ChargeAmount |
3585 |
Total Drug Medicare AllowedAmount |
2477.72 |
Total Drug Medicare PaymentAmount |
2410.32 |
Total Drug Medicare Standardized Payment Amount |
2410.32 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
970 |
Number Of Medicare Beneficiaries With Medical Services |
240 |
Total Medical Submitted Charge Amount |
113067 |
Total Medical Medicare Allowed Amount |
84018.02 |
Total Medical Medicare Payment Amount |
56949.96 |
Total Medical Medicare Standardized Payment Amount |
56221.7 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
178 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
142 |
Number Of Black or African American Beneficiaries |
70 |
Number Of AsianPacific Islander Beneficiaries |
15 |
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 |
188 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0103 |