National Provider Identifier [NPI]: |
1710005970 |
Last Name Of The Provider |
SHATS |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D., M.B.A. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
90 N 4TH ST |
Street Address 2 Of The Provider |
SUITE 300N |
City Of The Provider |
MARTINS FERRY |
Zip Code Of The Provider |
439351648 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
1206 |
Number Of Medicare Beneficiaries |
600 |
Total Submitted Charge Amount |
806529.08 |
Total Medicare Allowed Amount |
175386.12 |
Total Medicare Payment Amount |
136380.9 |
Total Medicare Standardized Payment Amount |
144574.06 |
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 |
45 |
Number Of Medical Services |
1206 |
Number Of Medicare Beneficiaries With Medical Services |
600 |
Total Medical Submitted Charge Amount |
806529.08 |
Total Medical Medicare Allowed Amount |
175386.12 |
Total Medical Medicare Payment Amount |
136380.9 |
Total Medical Medicare Standardized Payment Amount |
144574.06 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
194 |
Number Of Beneficiaries Age 65 to 74 |
225 |
Number Of Beneficiaries Age 75 to 84 |
134 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
311 |
Number Of Male Beneficiaries |
289 |
Number Of Non Hispanic White Beneficiaries |
579 |
Number Of Black or African American Beneficiaries |
|
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 |
317 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
283 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.6318 |