National Provider Identifier [NPI]: |
1487629879 |
Last Name Of The Provider |
O'HAGAN |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1930 BRAEBURN CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SALEM |
Zip Code Of The Provider |
241537388 |
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 |
121 |
Number Of Services |
6354 |
Number Of Medicare Beneficiaries |
817 |
Total Submitted Charge Amount |
545153 |
Total Medicare Allowed Amount |
243348.83 |
Total Medicare Payment Amount |
170072.12 |
Total Medicare Standardized Payment Amount |
175017.42 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
450 |
Number Of Medicare Beneficiaries With Drug Services |
213 |
Total Drug Submitted ChargeAmount |
15364 |
Total Drug Medicare AllowedAmount |
12508.23 |
Total Drug Medicare PaymentAmount |
11673.81 |
Total Drug Medicare Standardized Payment Amount |
11673.81 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
111 |
Number Of Medical Services |
5904 |
Number Of Medicare Beneficiaries With Medical Services |
817 |
Total Medical Submitted Charge Amount |
529789 |
Total Medical Medicare Allowed Amount |
230840.6 |
Total Medical Medicare Payment Amount |
158398.31 |
Total Medical Medicare Standardized Payment Amount |
163343.61 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
334 |
Number Of Beneficiaries Age 75 to 84 |
286 |
Number Of Beneficiaries Age Greater 84 |
138 |
Number Of Female Beneficiaries |
470 |
Number Of Male Beneficiaries |
347 |
Number Of Non Hispanic White Beneficiaries |
743 |
Number Of Black or African American Beneficiaries |
49 |
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 |
770 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9333 |