National Provider Identifier [NPI]: |
1154329548 |
Last Name Of The Provider |
SHELDON |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
750 E BELTLINE AVE NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRAND RAPIDS |
Zip Code Of The Provider |
495256049 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
441 |
Number Of Medicare Beneficiaries |
271 |
Total Submitted Charge Amount |
56845 |
Total Medicare Allowed Amount |
38611.74 |
Total Medicare Payment Amount |
25044.78 |
Total Medicare Standardized Payment Amount |
26412.64 |
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 |
19 |
Number Of Medical Services |
441 |
Number Of Medicare Beneficiaries With Medical Services |
271 |
Total Medical Submitted Charge Amount |
56845 |
Total Medical Medicare Allowed Amount |
38611.74 |
Total Medical Medicare Payment Amount |
25044.78 |
Total Medical Medicare Standardized Payment Amount |
26412.64 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
97 |
Number Of Beneficiaries Age Greater 84 |
56 |
Number Of Female Beneficiaries |
171 |
Number Of Male Beneficiaries |
100 |
Number Of Non Hispanic White Beneficiaries |
242 |
Number Of Black or African American Beneficiaries |
13 |
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 |
230 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1222 |