| National Provider Identifier [NPI]: | 1487702205 |
| Last Name Of The Provider | SHELTON |
| First Name Of The Provider | CORLISS |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7777 MILLIKEN AVE STE 350 |
| Street Address 2 Of The Provider | |
| City Of The Provider | RANCHO CUCAMONGA |
| Zip Code Of The Provider | 917306782 |
| 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 | 29 |
| Number Of Services | 561 |
| Number Of Medicare Beneficiaries | 112 |
| Total Submitted Charge Amount | 55537 |
| Total Medicare Allowed Amount | 33687.52 |
| Total Medicare Payment Amount | 26364.44 |
| Total Medicare Standardized Payment Amount | 25368.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 46 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 2120 |
| Total Drug Medicare AllowedAmount | 679.56 |
| Total Drug Medicare PaymentAmount | 664.61 |
| Total Drug Medicare Standardized Payment Amount | 664.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 515 |
| Number Of Medicare Beneficiaries With Medical Services | 112 |
| Total Medical Submitted Charge Amount | 53417 |
| Total Medical Medicare Allowed Amount | 33007.96 |
| Total Medical Medicare Payment Amount | 25699.83 |
| Total Medical Medicare Standardized Payment Amount | 24703.88 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 62 |
| Number Of Beneficiaries Age 75 to 84 | 21 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 95 |
| Number Of Male Beneficiaries | 17 |
| Number Of Non Hispanic White Beneficiaries | 51 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 76 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2081 |