National Provider Identifier [NPI]: |
1255306171 |
Last Name Of The Provider |
SHANG |
First Name Of The Provider |
SHERRY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
230 N BROAD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191021121 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
81 |
Number Of Services |
1689 |
Number Of Medicare Beneficiaries |
1015 |
Total Submitted Charge Amount |
554563 |
Total Medicare Allowed Amount |
53138.38 |
Total Medicare Payment Amount |
40506 |
Total Medicare Standardized Payment Amount |
38918.09 |
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 |
81 |
Number Of Medical Services |
1689 |
Number Of Medicare Beneficiaries With Medical Services |
1015 |
Total Medical Submitted Charge Amount |
554563 |
Total Medical Medicare Allowed Amount |
53138.38 |
Total Medical Medicare Payment Amount |
40506 |
Total Medical Medicare Standardized Payment Amount |
38918.09 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
420 |
Number Of Beneficiaries Age 65 to 74 |
329 |
Number Of Beneficiaries Age 75 to 84 |
160 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
510 |
Number Of Male Beneficiaries |
505 |
Number Of Non Hispanic White Beneficiaries |
363 |
Number Of Black or African American Beneficiaries |
559 |
Number Of AsianPacific Islander Beneficiaries |
31 |
Number Of Hispanic Beneficiaries |
48 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
462 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
553 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
3.0867 |