National Provider Identifier [NPI]: |
1780875781 |
Last Name Of The Provider |
SHIAN |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
X |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 HAWKINS DR |
Street Address 2 Of The Provider |
01105PFP |
City Of The Provider |
IOWA CITY |
Zip Code Of The Provider |
522421009 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
577 |
Number Of Medicare Beneficiaries |
261 |
Total Submitted Charge Amount |
160829 |
Total Medicare Allowed Amount |
50509.56 |
Total Medicare Payment Amount |
36935.25 |
Total Medicare Standardized Payment Amount |
36453.32 |
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 |
31 |
Number Of Medical Services |
577 |
Number Of Medicare Beneficiaries With Medical Services |
261 |
Total Medical Submitted Charge Amount |
160829 |
Total Medical Medicare Allowed Amount |
50509.56 |
Total Medical Medicare Payment Amount |
36935.25 |
Total Medical Medicare Standardized Payment Amount |
36453.32 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
141 |
Number Of Male Beneficiaries |
120 |
Number Of Non Hispanic White Beneficiaries |
211 |
Number Of Black or African American Beneficiaries |
23 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
138 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
123 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.6188 |