| National Provider Identifier [NPI]: | 1366401580 |
| Last Name Of The Provider | SHARP |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 17400 IRVINE BLVD M |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUSTIN |
| Zip Code Of The Provider | 927803030 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 155 |
| Number Of Medicare Beneficiaries | 45 |
| Total Submitted Charge Amount | 21690 |
| Total Medicare Allowed Amount | 14425.78 |
| Total Medicare Payment Amount | 11244.9 |
| Total Medicare Standardized Payment Amount | 10035.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 12 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 400 |
| Total Drug Medicare AllowedAmount | 124.42 |
| Total Drug Medicare PaymentAmount | 121.15 |
| Total Drug Medicare Standardized Payment Amount | 121.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 143 |
| Number Of Medicare Beneficiaries With Medical Services | 45 |
| Total Medical Submitted Charge Amount | 21290 |
| Total Medical Medicare Allowed Amount | 14301.36 |
| Total Medical Medicare Payment Amount | 11123.75 |
| Total Medical Medicare Standardized Payment Amount | 9914.04 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 26 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 32 |
| Number Of Male Beneficiaries | 13 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 34 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 0 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2535 |