National Provider Identifier [NPI]: |
1497983886 |
Last Name Of The Provider |
PERRY |
First Name Of The Provider |
ANGELICA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9524 HOSPITAL AVENUE |
Street Address 2 Of The Provider |
|
City Of The Provider |
NASSAWADOX |
Zip Code Of The Provider |
23413 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
108 |
Number Of Services |
6448 |
Number Of Medicare Beneficiaries |
603 |
Total Submitted Charge Amount |
305200.23 |
Total Medicare Allowed Amount |
193809.44 |
Total Medicare Payment Amount |
145097.28 |
Total Medicare Standardized Payment Amount |
147553.64 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
3693 |
Number Of Medicare Beneficiaries With Drug Services |
148 |
Total Drug Submitted ChargeAmount |
38682 |
Total Drug Medicare AllowedAmount |
27051.37 |
Total Drug Medicare PaymentAmount |
22791.02 |
Total Drug Medicare Standardized Payment Amount |
22791.02 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
95 |
Number Of Medical Services |
2755 |
Number Of Medicare Beneficiaries With Medical Services |
603 |
Total Medical Submitted Charge Amount |
266518.23 |
Total Medical Medicare Allowed Amount |
166758.07 |
Total Medical Medicare Payment Amount |
122306.26 |
Total Medical Medicare Standardized Payment Amount |
124762.62 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
236 |
Number Of Beneficiaries Age 75 to 84 |
163 |
Number Of Beneficiaries Age Greater 84 |
117 |
Number Of Female Beneficiaries |
382 |
Number Of Male Beneficiaries |
221 |
Number Of Non Hispanic White Beneficiaries |
454 |
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 |
395 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
208 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4115 |