National Provider Identifier [NPI]: |
1447340740 |
Last Name Of The Provider |
HENSLE |
First Name Of The Provider |
CRAIG |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
14904 JEFFERSON DAVIS HWY |
Street Address 2 Of The Provider |
SUITE 107 |
City Of The Provider |
WOODBRIDGE |
Zip Code Of The Provider |
221913908 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
1584 |
Number Of Medicare Beneficiaries |
762 |
Total Submitted Charge Amount |
358099.4 |
Total Medicare Allowed Amount |
183313.87 |
Total Medicare Payment Amount |
126806.33 |
Total Medicare Standardized Payment Amount |
131329.5 |
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 |
23 |
Number Of Medical Services |
1584 |
Number Of Medicare Beneficiaries With Medical Services |
762 |
Total Medical Submitted Charge Amount |
358099.4 |
Total Medical Medicare Allowed Amount |
183313.87 |
Total Medical Medicare Payment Amount |
126806.33 |
Total Medical Medicare Standardized Payment Amount |
131329.5 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
386 |
Number Of Beneficiaries Age 75 to 84 |
267 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
438 |
Number Of Male Beneficiaries |
324 |
Number Of Non Hispanic White Beneficiaries |
601 |
Number Of Black or African American Beneficiaries |
89 |
Number Of AsianPacific Islander Beneficiaries |
28 |
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
22 |
Number Of Beneficiaries With Medicare Only Entitlement |
723 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0008 |