National Provider Identifier [NPI]: |
1447570254 |
Last Name Of The Provider |
WEBB |
First Name Of The Provider |
JEREMY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2518 STEPHENSON AVE SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROANOKE |
Zip Code Of The Provider |
240141517 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
936 |
Number Of Medicare Beneficiaries |
839 |
Total Submitted Charge Amount |
659309 |
Total Medicare Allowed Amount |
129329.59 |
Total Medicare Payment Amount |
97956.36 |
Total Medicare Standardized Payment Amount |
100014.24 |
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 |
25 |
Number Of Medical Services |
936 |
Number Of Medicare Beneficiaries With Medical Services |
839 |
Total Medical Submitted Charge Amount |
659309 |
Total Medical Medicare Allowed Amount |
129329.59 |
Total Medical Medicare Payment Amount |
97956.36 |
Total Medical Medicare Standardized Payment Amount |
100014.24 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
246 |
Number Of Beneficiaries Age 65 to 74 |
204 |
Number Of Beneficiaries Age 75 to 84 |
211 |
Number Of Beneficiaries Age Greater 84 |
178 |
Number Of Female Beneficiaries |
494 |
Number Of Male Beneficiaries |
345 |
Number Of Non Hispanic White Beneficiaries |
783 |
Number Of Black or African American Beneficiaries |
43 |
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 |
544 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
295 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.6159 |