| National Provider Identifier [NPI]: | 1184682882 |
| Last Name Of The Provider | SHEFNER |
| First Name Of The Provider | JEREMY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 90 PRESIDENTIAL PLZ |
| Street Address 2 Of The Provider | 4TH FLOOR |
| City Of The Provider | SYRACUSE |
| Zip Code Of The Provider | 132022240 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 12720 |
| Number Of Medicare Beneficiaries | 72 |
| Total Submitted Charge Amount | 156237.5 |
| Total Medicare Allowed Amount | 90718.34 |
| Total Medicare Payment Amount | 67887.55 |
| Total Medicare Standardized Payment Amount | 68209.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 12550 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 112200 |
| Total Drug Medicare AllowedAmount | 73428.15 |
| Total Drug Medicare PaymentAmount | 55896.55 |
| Total Drug Medicare Standardized Payment Amount | 55896.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 170 |
| Number Of Medicare Beneficiaries With Medical Services | 72 |
| Total Medical Submitted Charge Amount | 44037.5 |
| Total Medical Medicare Allowed Amount | 17290.19 |
| Total Medical Medicare Payment Amount | 11991 |
| Total Medical Medicare Standardized Payment Amount | 12312.81 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 25 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 38 |
| Number Of Male Beneficiaries | 34 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 44 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3767 |