National Provider Identifier [NPI]: |
1760479257 |
Last Name Of The Provider |
NEELY |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2367 COLONY CROSSING PLACE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MIDLOTHIAN |
Zip Code Of The Provider |
23112 |
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 |
59 |
Number Of Services |
1433 |
Number Of Medicare Beneficiaries |
313 |
Total Submitted Charge Amount |
129515 |
Total Medicare Allowed Amount |
100253.59 |
Total Medicare Payment Amount |
72078.53 |
Total Medicare Standardized Payment Amount |
74598.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
266 |
Number Of Medicare Beneficiaries With Drug Services |
158 |
Total Drug Submitted ChargeAmount |
11907 |
Total Drug Medicare AllowedAmount |
7806.37 |
Total Drug Medicare PaymentAmount |
7381.27 |
Total Drug Medicare Standardized Payment Amount |
7381.27 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
1167 |
Number Of Medicare Beneficiaries With Medical Services |
313 |
Total Medical Submitted Charge Amount |
117608 |
Total Medical Medicare Allowed Amount |
92447.22 |
Total Medical Medicare Payment Amount |
64697.26 |
Total Medical Medicare Standardized Payment Amount |
67217.33 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
182 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
160 |
Number Of Male Beneficiaries |
153 |
Number Of Non Hispanic White Beneficiaries |
267 |
Number Of Black or African American Beneficiaries |
31 |
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 |
291 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9079 |