National Provider Identifier [NPI]: |
1497791008 |
Last Name Of The Provider |
SHEIMAN |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2900 MAIN ST |
Street Address 2 Of The Provider |
SUITE 2A |
City Of The Provider |
STRATFORD |
Zip Code Of The Provider |
066144946 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
418 |
Number Of Medicare Beneficiaries |
105 |
Total Submitted Charge Amount |
40104 |
Total Medicare Allowed Amount |
34299.84 |
Total Medicare Payment Amount |
24330.84 |
Total Medicare Standardized Payment Amount |
23224.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
15 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
375 |
Total Drug Medicare AllowedAmount |
231 |
Total Drug Medicare PaymentAmount |
226.35 |
Total Drug Medicare Standardized Payment Amount |
226.35 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
403 |
Number Of Medicare Beneficiaries With Medical Services |
105 |
Total Medical Submitted Charge Amount |
39729 |
Total Medical Medicare Allowed Amount |
34068.84 |
Total Medical Medicare Payment Amount |
24104.49 |
Total Medical Medicare Standardized Payment Amount |
22998.43 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
44 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
68 |
Number Of Male Beneficiaries |
37 |
Number Of Non Hispanic White Beneficiaries |
66 |
Number Of Black or African American Beneficiaries |
25 |
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 |
52 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
22 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2704 |