National Provider Identifier [NPI]: |
1316258932 |
Last Name Of The Provider |
SHELDON |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2704 SMITH CREEK RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
AUGUSTA |
Zip Code Of The Provider |
309092322 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
962 |
Number Of Medicare Beneficiaries |
827 |
Total Submitted Charge Amount |
874647 |
Total Medicare Allowed Amount |
131179.07 |
Total Medicare Payment Amount |
100018.74 |
Total Medicare Standardized Payment Amount |
102348.9 |
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 |
23 |
Number Of Medical Services |
962 |
Number Of Medicare Beneficiaries With Medical Services |
827 |
Total Medical Submitted Charge Amount |
874647 |
Total Medical Medicare Allowed Amount |
131179.07 |
Total Medical Medicare Payment Amount |
100018.74 |
Total Medical Medicare Standardized Payment Amount |
102348.9 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
248 |
Number Of Beneficiaries Age 65 to 74 |
234 |
Number Of Beneficiaries Age 75 to 84 |
215 |
Number Of Beneficiaries Age Greater 84 |
130 |
Number Of Female Beneficiaries |
498 |
Number Of Male Beneficiaries |
329 |
Number Of Non Hispanic White Beneficiaries |
491 |
Number Of Black or African American Beneficiaries |
311 |
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 |
537 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
290 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0231 |