National Provider Identifier [NPI]: |
1811157753 |
Last Name Of The Provider |
SHEFVELAND |
First Name Of The Provider |
NATHAN |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2251 N SHORE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
RHINELANDER |
Zip Code Of The Provider |
545016710 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
665 |
Number Of Medicare Beneficiaries |
434 |
Total Submitted Charge Amount |
385847.5 |
Total Medicare Allowed Amount |
69552.54 |
Total Medicare Payment Amount |
51506.1 |
Total Medicare Standardized Payment Amount |
53442.19 |
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 |
22 |
Number Of Medical Services |
665 |
Number Of Medicare Beneficiaries With Medical Services |
434 |
Total Medical Submitted Charge Amount |
385847.5 |
Total Medical Medicare Allowed Amount |
69552.54 |
Total Medical Medicare Payment Amount |
51506.1 |
Total Medical Medicare Standardized Payment Amount |
53442.19 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
119 |
Number Of Beneficiaries Age 65 to 74 |
122 |
Number Of Beneficiaries Age 75 to 84 |
118 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
241 |
Number Of Male Beneficiaries |
193 |
Number Of Non Hispanic White Beneficiaries |
408 |
Number Of Black or African American Beneficiaries |
|
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 |
265 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
169 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5393 |