| National Provider Identifier [NPI]: | 1659345692 |
| Last Name Of The Provider | SHRUM |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1100 E HIGH ST |
| Street Address 2 Of The Provider | STE 1C |
| City Of The Provider | CHARLOTTESVILLE |
| Zip Code Of The Provider | 22902 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 7811 |
| Number Of Medicare Beneficiaries | 1169 |
| Total Submitted Charge Amount | 441836.74 |
| Total Medicare Allowed Amount | 278390.77 |
| Total Medicare Payment Amount | 194968.65 |
| Total Medicare Standardized Payment Amount | 190413.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 518 |
| Number Of Medicare Beneficiaries With Drug Services | 90 |
| Total Drug Submitted ChargeAmount | 2590 |
| Total Drug Medicare AllowedAmount | 924.26 |
| Total Drug Medicare PaymentAmount | 656.82 |
| Total Drug Medicare Standardized Payment Amount | 656.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 7293 |
| Number Of Medicare Beneficiaries With Medical Services | 1169 |
| Total Medical Submitted Charge Amount | 439246.74 |
| Total Medical Medicare Allowed Amount | 277466.51 |
| Total Medical Medicare Payment Amount | 194311.83 |
| Total Medical Medicare Standardized Payment Amount | 189756.63 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 86 |
| Number Of Beneficiaries Age 65 to 74 | 396 |
| Number Of Beneficiaries Age 75 to 84 | 441 |
| Number Of Beneficiaries Age Greater 84 | 246 |
| Number Of Female Beneficiaries | 613 |
| Number Of Male Beneficiaries | 556 |
| Number Of Non Hispanic White Beneficiaries | 1109 |
| Number Of Black or African American Beneficiaries | 45 |
| 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 | 1024 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 145 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0294 |