| National Provider Identifier [NPI]: | 1073590071 |
| Last Name Of The Provider | SHIELD |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1144 PROFESSIONAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | WILLIAMSBURG |
| Zip Code Of The Provider | 231853330 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 13102 |
| Number Of Medicare Beneficiaries | 353 |
| Total Submitted Charge Amount | 337538.89 |
| Total Medicare Allowed Amount | 260484.61 |
| Total Medicare Payment Amount | 197300.98 |
| Total Medicare Standardized Payment Amount | 196418.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 4887 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 134798 |
| Total Drug Medicare AllowedAmount | 130636.08 |
| Total Drug Medicare PaymentAmount | 102626.75 |
| Total Drug Medicare Standardized Payment Amount | 102626.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 8215 |
| Number Of Medicare Beneficiaries With Medical Services | 353 |
| Total Medical Submitted Charge Amount | 202740.89 |
| Total Medical Medicare Allowed Amount | 129848.53 |
| Total Medical Medicare Payment Amount | 94674.23 |
| Total Medical Medicare Standardized Payment Amount | 93791.48 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 213 |
| Number Of Beneficiaries Age 75 to 84 | 95 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 240 |
| Number Of Male Beneficiaries | 113 |
| Number Of Non Hispanic White Beneficiaries | 315 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 33 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7403 |