National Provider Identifier [NPI]: |
1215900295 |
Last Name Of The Provider |
YOUNG |
First Name Of The Provider |
SHELLEY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
401 CORBETT ST |
Street Address 2 Of The Provider |
SUITE 400 |
City Of The Provider |
BELLEAIR |
Zip Code Of The Provider |
337567309 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
753 |
Number Of Medicare Beneficiaries |
309 |
Total Submitted Charge Amount |
165059.42 |
Total Medicare Allowed Amount |
63415.53 |
Total Medicare Payment Amount |
51370.84 |
Total Medicare Standardized Payment Amount |
51579.97 |
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 |
37 |
Number Of Medical Services |
753 |
Number Of Medicare Beneficiaries With Medical Services |
309 |
Total Medical Submitted Charge Amount |
165059.42 |
Total Medical Medicare Allowed Amount |
63415.53 |
Total Medical Medicare Payment Amount |
51370.84 |
Total Medical Medicare Standardized Payment Amount |
51579.97 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
163 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
309 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
290 |
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 |
297 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
15 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.867 |