National Provider Identifier [NPI]: |
1427038363 |
Last Name Of The Provider |
SHERRON |
First Name Of The Provider |
FREDERICK |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
601 TEXAN TRL |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
CORPUS CHRISTI |
Zip Code Of The Provider |
784112547 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
75 |
Number Of Services |
2824 |
Number Of Medicare Beneficiaries |
256 |
Total Submitted Charge Amount |
157434.5 |
Total Medicare Allowed Amount |
103536.56 |
Total Medicare Payment Amount |
73674.53 |
Total Medicare Standardized Payment Amount |
78712.11 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
164 |
Number Of Medicare Beneficiaries With Drug Services |
118 |
Total Drug Submitted ChargeAmount |
4336.5 |
Total Drug Medicare AllowedAmount |
2751.35 |
Total Drug Medicare PaymentAmount |
2633.18 |
Total Drug Medicare Standardized Payment Amount |
2633.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
61 |
Number Of Medical Services |
2660 |
Number Of Medicare Beneficiaries With Medical Services |
256 |
Total Medical Submitted Charge Amount |
153098 |
Total Medical Medicare Allowed Amount |
100785.21 |
Total Medical Medicare Payment Amount |
71041.35 |
Total Medical Medicare Standardized Payment Amount |
76078.93 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
82 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
141 |
Number Of Male Beneficiaries |
115 |
Number Of Non Hispanic White Beneficiaries |
173 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
71 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
238 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8687 |