National Provider Identifier [NPI]: |
1083677322 |
Last Name Of The Provider |
ISAAC |
First Name Of The Provider |
SHAUN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
603 7TH ST S |
Street Address 2 Of The Provider |
SUITE 330 |
City Of The Provider |
ST PETERSBURG |
Zip Code Of The Provider |
337014719 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
1479 |
Number Of Medicare Beneficiaries |
491 |
Total Submitted Charge Amount |
547780 |
Total Medicare Allowed Amount |
141206.79 |
Total Medicare Payment Amount |
109126.63 |
Total Medicare Standardized Payment Amount |
104373.82 |
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 |
18 |
Number Of Medical Services |
1479 |
Number Of Medicare Beneficiaries With Medical Services |
491 |
Total Medical Submitted Charge Amount |
547780 |
Total Medical Medicare Allowed Amount |
141206.79 |
Total Medical Medicare Payment Amount |
109126.63 |
Total Medical Medicare Standardized Payment Amount |
104373.82 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
141 |
Number Of Beneficiaries Age 75 to 84 |
141 |
Number Of Beneficiaries Age Greater 84 |
111 |
Number Of Female Beneficiaries |
265 |
Number Of Male Beneficiaries |
226 |
Number Of Non Hispanic White Beneficiaries |
382 |
Number Of Black or African American Beneficiaries |
51 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
47 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
334 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
157 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.2766 |