National Provider Identifier [NPI]: |
1538223870 |
Last Name Of The Provider |
SHELTON |
First Name Of The Provider |
ROBERT |
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 |
100 HOSPITAL RD |
Street Address 2 Of The Provider |
SUITE 2B |
City Of The Provider |
LEOMINSTER |
Zip Code Of The Provider |
014532253 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
105 |
Number Of Services |
903 |
Number Of Medicare Beneficiaries |
332 |
Total Submitted Charge Amount |
452590 |
Total Medicare Allowed Amount |
156612.21 |
Total Medicare Payment Amount |
120209.09 |
Total Medicare Standardized Payment Amount |
118441.22 |
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 |
105 |
Number Of Medical Services |
903 |
Number Of Medicare Beneficiaries With Medical Services |
332 |
Total Medical Submitted Charge Amount |
452590 |
Total Medical Medicare Allowed Amount |
156612.21 |
Total Medical Medicare Payment Amount |
120209.09 |
Total Medical Medicare Standardized Payment Amount |
118441.22 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
130 |
Number Of Beneficiaries Age 75 to 84 |
73 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
159 |
Number Of Male Beneficiaries |
173 |
Number Of Non Hispanic White Beneficiaries |
297 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
216 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
116 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.8142 |