National Provider Identifier [NPI]: |
1659373561 |
Last Name Of The Provider |
SHIELDS |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12605 E 16TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
AURORA |
Zip Code Of The Provider |
800452545 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
2716 |
Number Of Medicare Beneficiaries |
673 |
Total Submitted Charge Amount |
597616 |
Total Medicare Allowed Amount |
147161.93 |
Total Medicare Payment Amount |
103244.56 |
Total Medicare Standardized Payment Amount |
103091.07 |
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 |
27 |
Number Of Medical Services |
2716 |
Number Of Medicare Beneficiaries With Medical Services |
673 |
Total Medical Submitted Charge Amount |
597616 |
Total Medical Medicare Allowed Amount |
147161.93 |
Total Medical Medicare Payment Amount |
103244.56 |
Total Medical Medicare Standardized Payment Amount |
103091.07 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
220 |
Number Of Beneficiaries Age 75 to 84 |
237 |
Number Of Beneficiaries Age Greater 84 |
189 |
Number Of Female Beneficiaries |
417 |
Number Of Male Beneficiaries |
256 |
Number Of Non Hispanic White Beneficiaries |
563 |
Number Of Black or African American Beneficiaries |
47 |
Number Of AsianPacific Islander Beneficiaries |
17 |
Number Of Hispanic Beneficiaries |
31 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
15 |
Number Of Beneficiaries With Medicare Only Entitlement |
608 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0865 |