National Provider Identifier [NPI]: |
1083767917 |
Last Name Of The Provider |
SHEPARD |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
795 EL CAMINO REAL |
Street Address 2 Of The Provider |
|
City Of The Provider |
PALO ALTO |
Zip Code Of The Provider |
943012302 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
104 |
Number Of Services |
21168 |
Number Of Medicare Beneficiaries |
855 |
Total Submitted Charge Amount |
1077839 |
Total Medicare Allowed Amount |
221132.5 |
Total Medicare Payment Amount |
169695.85 |
Total Medicare Standardized Payment Amount |
135739.3 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
20093 |
Number Of Medicare Beneficiaries With Drug Services |
196 |
Total Drug Submitted ChargeAmount |
23461 |
Total Drug Medicare AllowedAmount |
5486.09 |
Total Drug Medicare PaymentAmount |
4300.67 |
Total Drug Medicare Standardized Payment Amount |
4300.67 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
101 |
Number Of Medical Services |
1075 |
Number Of Medicare Beneficiaries With Medical Services |
855 |
Total Medical Submitted Charge Amount |
1054378 |
Total Medical Medicare Allowed Amount |
215646.41 |
Total Medical Medicare Payment Amount |
165395.18 |
Total Medical Medicare Standardized Payment Amount |
131438.63 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
418 |
Number Of Beneficiaries Age 75 to 84 |
259 |
Number Of Beneficiaries Age Greater 84 |
126 |
Number Of Female Beneficiaries |
520 |
Number Of Male Beneficiaries |
335 |
Number Of Non Hispanic White Beneficiaries |
618 |
Number Of Black or African American Beneficiaries |
21 |
Number Of AsianPacific Islander Beneficiaries |
132 |
Number Of Hispanic Beneficiaries |
53 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
31 |
Number Of Beneficiaries With Medicare Only Entitlement |
733 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
122 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0468 |