National Provider Identifier [NPI]: |
1780643163 |
Last Name Of The Provider |
SHIRES |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2103 INGERSOLL AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
DES MOINES |
Zip Code Of The Provider |
503125262 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
100 |
Number Of Services |
4469 |
Number Of Medicare Beneficiaries |
440 |
Total Submitted Charge Amount |
297690 |
Total Medicare Allowed Amount |
131801.55 |
Total Medicare Payment Amount |
97185.37 |
Total Medicare Standardized Payment Amount |
105210.94 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
482 |
Number Of Medicare Beneficiaries With Drug Services |
139 |
Total Drug Submitted ChargeAmount |
13354 |
Total Drug Medicare AllowedAmount |
9115.55 |
Total Drug Medicare PaymentAmount |
7942.77 |
Total Drug Medicare Standardized Payment Amount |
7942.77 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
92 |
Number Of Medical Services |
3987 |
Number Of Medicare Beneficiaries With Medical Services |
440 |
Total Medical Submitted Charge Amount |
284336 |
Total Medical Medicare Allowed Amount |
122686 |
Total Medical Medicare Payment Amount |
89242.6 |
Total Medical Medicare Standardized Payment Amount |
97268.17 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
207 |
Number Of Beneficiaries Age 75 to 84 |
109 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
223 |
Number Of Male Beneficiaries |
217 |
Number Of Non Hispanic White Beneficiaries |
399 |
Number Of Black or African American Beneficiaries |
21 |
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 |
380 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.867 |