National Provider Identifier [NPI]: |
1124016928 |
Last Name Of The Provider |
O'SHEA |
First Name Of The Provider |
NOREEN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
204 E MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ELK POINT |
Zip Code Of The Provider |
570250798 |
State Code Of The Provider |
SD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
722 |
Number Of Medicare Beneficiaries |
228 |
Total Submitted Charge Amount |
48741 |
Total Medicare Allowed Amount |
26169.99 |
Total Medicare Payment Amount |
19178.38 |
Total Medicare Standardized Payment Amount |
20707.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
70 |
Number Of Medicare Beneficiaries With Drug Services |
36 |
Total Drug Submitted ChargeAmount |
5409 |
Total Drug Medicare AllowedAmount |
2160.27 |
Total Drug Medicare PaymentAmount |
2029.75 |
Total Drug Medicare Standardized Payment Amount |
2029.75 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
652 |
Number Of Medicare Beneficiaries With Medical Services |
227 |
Total Medical Submitted Charge Amount |
43332 |
Total Medical Medicare Allowed Amount |
24009.72 |
Total Medical Medicare Payment Amount |
17148.63 |
Total Medical Medicare Standardized Payment Amount |
18677.56 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
104 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
147 |
Number Of Male Beneficiaries |
81 |
Number Of Non Hispanic White Beneficiaries |
205 |
Number Of Black or African American Beneficiaries |
11 |
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 |
151 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2362 |