National Provider Identifier [NPI]: |
1598873127 |
Last Name Of The Provider |
SHUMWAY |
First Name Of The Provider |
JUDY |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7330 SAN PEDRO |
Street Address 2 Of The Provider |
STE. 405 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782166235 |
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 |
20 |
Number Of Services |
1000 |
Number Of Medicare Beneficiaries |
558 |
Total Submitted Charge Amount |
229226 |
Total Medicare Allowed Amount |
109338.56 |
Total Medicare Payment Amount |
84541.08 |
Total Medicare Standardized Payment Amount |
87789.17 |
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 |
20 |
Number Of Medical Services |
1000 |
Number Of Medicare Beneficiaries With Medical Services |
558 |
Total Medical Submitted Charge Amount |
229226 |
Total Medical Medicare Allowed Amount |
109338.56 |
Total Medical Medicare Payment Amount |
84541.08 |
Total Medical Medicare Standardized Payment Amount |
87789.17 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
179 |
Number Of Beneficiaries Age 75 to 84 |
184 |
Number Of Beneficiaries Age Greater 84 |
120 |
Number Of Female Beneficiaries |
304 |
Number Of Male Beneficiaries |
254 |
Number Of Non Hispanic White Beneficiaries |
434 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
100 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
473 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.1682 |