National Provider Identifier [NPI]: |
1376731695 |
Last Name Of The Provider |
SHERROD |
First Name Of The Provider |
SUE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4925 SUGAR MILL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752446935 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
421 |
Number Of Medicare Beneficiaries |
137 |
Total Submitted Charge Amount |
26013.68 |
Total Medicare Allowed Amount |
24383.32 |
Total Medicare Payment Amount |
17471.13 |
Total Medicare Standardized Payment Amount |
20826.96 |
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 |
12 |
Number Of Medical Services |
421 |
Number Of Medicare Beneficiaries With Medical Services |
137 |
Total Medical Submitted Charge Amount |
26013.68 |
Total Medical Medicare Allowed Amount |
24383.32 |
Total Medical Medicare Payment Amount |
17471.13 |
Total Medical Medicare Standardized Payment Amount |
20826.96 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
27 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
87 |
Number Of Male Beneficiaries |
50 |
Number Of Non Hispanic White Beneficiaries |
85 |
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 |
51 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
86 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
63 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
38 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.4727 |