National Provider Identifier [NPI]: |
1104886514 |
Last Name Of The Provider |
SHERMAN |
First Name Of The Provider |
STANLEY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1133 SEMINOLE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCKLEDGE |
Zip Code Of The Provider |
329552836 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
113 |
Number Of Services |
573 |
Number Of Medicare Beneficiaries |
193 |
Total Submitted Charge Amount |
323425 |
Total Medicare Allowed Amount |
121999.2 |
Total Medicare Payment Amount |
91555.12 |
Total Medicare Standardized Payment Amount |
92599.85 |
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 |
113 |
Number Of Medical Services |
573 |
Number Of Medicare Beneficiaries With Medical Services |
193 |
Total Medical Submitted Charge Amount |
323425 |
Total Medical Medicare Allowed Amount |
121999.2 |
Total Medical Medicare Payment Amount |
91555.12 |
Total Medical Medicare Standardized Payment Amount |
92599.85 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
104 |
Number Of Male Beneficiaries |
89 |
Number Of Non Hispanic White Beneficiaries |
158 |
Number Of Black or African American Beneficiaries |
|
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 |
140 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.38 |