National Provider Identifier [NPI]: |
1760402846 |
Last Name Of The Provider |
SHAPIRO |
First Name Of The Provider |
SHELLEY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 MEDICAL PLAZA |
Street Address 2 Of The Provider |
#365,530,420,120 |
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
90095 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
518 |
Number Of Medicare Beneficiaries |
142 |
Total Submitted Charge Amount |
174156 |
Total Medicare Allowed Amount |
46959.65 |
Total Medicare Payment Amount |
35634.24 |
Total Medicare Standardized Payment Amount |
33508.44 |
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 |
6 |
Number Of Medical Services |
518 |
Number Of Medicare Beneficiaries With Medical Services |
142 |
Total Medical Submitted Charge Amount |
174156 |
Total Medical Medicare Allowed Amount |
46959.65 |
Total Medical Medicare Payment Amount |
35634.24 |
Total Medical Medicare Standardized Payment Amount |
33508.44 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
58 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
95 |
Number Of Male Beneficiaries |
47 |
Number Of Non Hispanic White Beneficiaries |
81 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
34 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
96 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.5235 |