National Provider Identifier [NPI]: |
1427080324 |
Last Name Of The Provider |
SHULMISTER |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4092 FOXWOOD DR |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
VIRGINIA BEACH |
Zip Code Of The Provider |
234625225 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
1258 |
Number Of Medicare Beneficiaries |
814 |
Total Submitted Charge Amount |
384273 |
Total Medicare Allowed Amount |
120722.53 |
Total Medicare Payment Amount |
90149.11 |
Total Medicare Standardized Payment Amount |
93341.92 |
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 |
1258 |
Number Of Medicare Beneficiaries With Medical Services |
814 |
Total Medical Submitted Charge Amount |
384273 |
Total Medical Medicare Allowed Amount |
120722.53 |
Total Medical Medicare Payment Amount |
90149.11 |
Total Medical Medicare Standardized Payment Amount |
93341.92 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
161 |
Number Of Beneficiaries Age 65 to 74 |
280 |
Number Of Beneficiaries Age 75 to 84 |
247 |
Number Of Beneficiaries Age Greater 84 |
126 |
Number Of Female Beneficiaries |
517 |
Number Of Male Beneficiaries |
297 |
Number Of Non Hispanic White Beneficiaries |
543 |
Number Of Black or African American Beneficiaries |
181 |
Number Of AsianPacific Islander Beneficiaries |
37 |
Number Of Hispanic Beneficiaries |
39 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
658 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
156 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.0056 |