National Provider Identifier [NPI]: |
1942236336 |
Last Name Of The Provider |
SHOE |
First Name Of The Provider |
SHERRI |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
621 S NEW BALLAS RD |
Street Address 2 Of The Provider |
SUITE 63B |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631418232 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
594 |
Number Of Medicare Beneficiaries |
192 |
Total Submitted Charge Amount |
319340 |
Total Medicare Allowed Amount |
33655.07 |
Total Medicare Payment Amount |
24940.02 |
Total Medicare Standardized Payment Amount |
28323.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
148 |
Number Of Medicare Beneficiaries With Drug Services |
56 |
Total Drug Submitted ChargeAmount |
3129 |
Total Drug Medicare AllowedAmount |
1407.66 |
Total Drug Medicare PaymentAmount |
1088.11 |
Total Drug Medicare Standardized Payment Amount |
1088.11 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
58 |
Number Of Medical Services |
446 |
Number Of Medicare Beneficiaries With Medical Services |
192 |
Total Medical Submitted Charge Amount |
316211 |
Total Medical Medicare Allowed Amount |
32247.41 |
Total Medical Medicare Payment Amount |
23851.91 |
Total Medical Medicare Standardized Payment Amount |
27235.04 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
128 |
Number Of Male Beneficiaries |
64 |
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 |
177 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
0.9945 |