National Provider Identifier [NPI]: |
1982682159 |
Last Name Of The Provider |
SHERMAN |
First Name Of The Provider |
DENISE |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3309 UNIVERSITY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TYLER |
Zip Code Of The Provider |
75701 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
3201 |
Number Of Medicare Beneficiaries |
482 |
Total Submitted Charge Amount |
354364 |
Total Medicare Allowed Amount |
193346.54 |
Total Medicare Payment Amount |
146575.84 |
Total Medicare Standardized Payment Amount |
159604.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
320 |
Number Of Medicare Beneficiaries With Drug Services |
229 |
Total Drug Submitted ChargeAmount |
14900 |
Total Drug Medicare AllowedAmount |
10645.01 |
Total Drug Medicare PaymentAmount |
10384.06 |
Total Drug Medicare Standardized Payment Amount |
10384.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
35 |
Number Of Medical Services |
2881 |
Number Of Medicare Beneficiaries With Medical Services |
482 |
Total Medical Submitted Charge Amount |
339464 |
Total Medical Medicare Allowed Amount |
182701.53 |
Total Medical Medicare Payment Amount |
136191.78 |
Total Medical Medicare Standardized Payment Amount |
149220.87 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
246 |
Number Of Beneficiaries Age 75 to 84 |
161 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
378 |
Number Of Male Beneficiaries |
104 |
Number Of Non Hispanic White Beneficiaries |
460 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
2 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
8 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
7 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.7919 |