| National Provider Identifier [NPI]: | 1255350625 |
| Last Name Of The Provider | KING |
| First Name Of The Provider | BRENDA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | N.P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1250 E MARSHALL ST |
| Street Address 2 Of The Provider | DERMATOLOGY |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 232985051 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 1895 |
| Number Of Medicare Beneficiaries | 507 |
| Total Submitted Charge Amount | 186965 |
| Total Medicare Allowed Amount | 107284.04 |
| Total Medicare Payment Amount | 76487.45 |
| Total Medicare Standardized Payment Amount | 87726.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 28 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 1194 |
| Total Drug Medicare AllowedAmount | 1038.96 |
| Total Drug Medicare PaymentAmount | 783.56 |
| Total Drug Medicare Standardized Payment Amount | 783.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 1867 |
| Number Of Medicare Beneficiaries With Medical Services | 507 |
| Total Medical Submitted Charge Amount | 185771 |
| Total Medical Medicare Allowed Amount | 106245.08 |
| Total Medical Medicare Payment Amount | 75703.89 |
| Total Medical Medicare Standardized Payment Amount | 86942.91 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 268 |
| Number Of Beneficiaries Age 75 to 84 | 148 |
| Number Of Beneficiaries Age Greater 84 | 48 |
| Number Of Female Beneficiaries | 319 |
| Number Of Male Beneficiaries | 188 |
| Number Of Non Hispanic White Beneficiaries | 463 |
| Number Of Black or African American Beneficiaries | 33 |
| 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 | 461 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0126 |