National Provider Identifier [NPI]: |
1407014426 |
Last Name Of The Provider |
SHERIDAN |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8433 HARCOURT RD STE 100 |
Street Address 2 Of The Provider |
|
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462602193 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
117 |
Number Of Services |
2237 |
Number Of Medicare Beneficiaries |
812 |
Total Submitted Charge Amount |
1400054 |
Total Medicare Allowed Amount |
362641.59 |
Total Medicare Payment Amount |
269792.56 |
Total Medicare Standardized Payment Amount |
297430.87 |
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 |
117 |
Number Of Medical Services |
2237 |
Number Of Medicare Beneficiaries With Medical Services |
812 |
Total Medical Submitted Charge Amount |
1400054 |
Total Medical Medicare Allowed Amount |
362641.59 |
Total Medical Medicare Payment Amount |
269792.56 |
Total Medical Medicare Standardized Payment Amount |
297430.87 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
94 |
Number Of Beneficiaries Age 65 to 74 |
318 |
Number Of Beneficiaries Age 75 to 84 |
276 |
Number Of Beneficiaries Age Greater 84 |
124 |
Number Of Female Beneficiaries |
375 |
Number Of Male Beneficiaries |
437 |
Number Of Non Hispanic White Beneficiaries |
719 |
Number Of Black or African American Beneficiaries |
78 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
685 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
127 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.0887 |