| National Provider Identifier [NPI]: | 1073535456 |
| Last Name Of The Provider | SHIELDS |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 340 BANTAM RD |
| Street Address 2 Of The Provider | SUITE 1-B |
| City Of The Provider | LITCHFIELD |
| Zip Code Of The Provider | 067593318 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 2160 |
| Number Of Medicare Beneficiaries | 560 |
| Total Submitted Charge Amount | 120802.37 |
| Total Medicare Allowed Amount | 117975.02 |
| Total Medicare Payment Amount | 80200.87 |
| Total Medicare Standardized Payment Amount | 75980.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 18 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 33.4 |
| Total Drug Medicare AllowedAmount | 32.12 |
| Total Drug Medicare PaymentAmount | 18.19 |
| Total Drug Medicare Standardized Payment Amount | 18.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 2142 |
| Number Of Medicare Beneficiaries With Medical Services | 560 |
| Total Medical Submitted Charge Amount | 120768.97 |
| Total Medical Medicare Allowed Amount | 117942.9 |
| Total Medical Medicare Payment Amount | 80182.68 |
| Total Medical Medicare Standardized Payment Amount | 75962.05 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 123 |
| Number Of Beneficiaries Age 75 to 84 | 183 |
| Number Of Beneficiaries Age Greater 84 | 233 |
| Number Of Female Beneficiaries | 358 |
| Number Of Male Beneficiaries | 202 |
| Number Of Non Hispanic White Beneficiaries | 538 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 435 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 125 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3604 |