National Provider Identifier [NPI]: |
1497752505 |
Last Name Of The Provider |
ALBA |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
130 ENTERPRISE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
DANVILLE |
Zip Code Of The Provider |
245404070 |
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 |
92 |
Number Of Services |
2441 |
Number Of Medicare Beneficiaries |
584 |
Total Submitted Charge Amount |
121037.01 |
Total Medicare Allowed Amount |
85094.96 |
Total Medicare Payment Amount |
58732.89 |
Total Medicare Standardized Payment Amount |
61829.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
16 |
Number Of Drug Services |
351 |
Number Of Medicare Beneficiaries With Drug Services |
159 |
Total Drug Submitted ChargeAmount |
6161.3 |
Total Drug Medicare AllowedAmount |
2017.66 |
Total Drug Medicare PaymentAmount |
1831.18 |
Total Drug Medicare Standardized Payment Amount |
1831.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
76 |
Number Of Medical Services |
2090 |
Number Of Medicare Beneficiaries With Medical Services |
583 |
Total Medical Submitted Charge Amount |
114875.71 |
Total Medical Medicare Allowed Amount |
83077.3 |
Total Medical Medicare Payment Amount |
56901.71 |
Total Medical Medicare Standardized Payment Amount |
59997.83 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
247 |
Number Of Beneficiaries Age 75 to 84 |
181 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
350 |
Number Of Male Beneficiaries |
234 |
Number Of Non Hispanic White Beneficiaries |
426 |
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 |
487 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
97 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0493 |