National Provider Identifier [NPI]: |
1114038205 |
Last Name Of The Provider |
EDWARDS |
First Name Of The Provider |
ALAN |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 FAIRVIEW DR |
Street Address 2 Of The Provider |
SUITE 101 SOUTHAMPTON MEDICAL BLDG |
City Of The Provider |
FRANKLIN |
Zip Code Of The Provider |
23851 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
6142 |
Number Of Medicare Beneficiaries |
1049 |
Total Submitted Charge Amount |
699536 |
Total Medicare Allowed Amount |
355850.62 |
Total Medicare Payment Amount |
258022.27 |
Total Medicare Standardized Payment Amount |
262637.48 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
57 |
Number Of Medicare Beneficiaries With Drug Services |
41 |
Total Drug Submitted ChargeAmount |
594 |
Total Drug Medicare AllowedAmount |
98.01 |
Total Drug Medicare PaymentAmount |
75.34 |
Total Drug Medicare Standardized Payment Amount |
75.34 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
6085 |
Number Of Medicare Beneficiaries With Medical Services |
1049 |
Total Medical Submitted Charge Amount |
698942 |
Total Medical Medicare Allowed Amount |
355752.61 |
Total Medical Medicare Payment Amount |
257946.93 |
Total Medical Medicare Standardized Payment Amount |
262562.14 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
137 |
Number Of Beneficiaries Age 65 to 74 |
369 |
Number Of Beneficiaries Age 75 to 84 |
330 |
Number Of Beneficiaries Age Greater 84 |
213 |
Number Of Female Beneficiaries |
613 |
Number Of Male Beneficiaries |
436 |
Number Of Non Hispanic White Beneficiaries |
663 |
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 |
761 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
288 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.544 |