| National Provider Identifier [NPI]: | 1659379774 |
| Last Name Of The Provider | HUMPHREYS |
| First Name Of The Provider | KATHRYN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4830 RUCKER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MONETA |
| Zip Code Of The Provider | 241215281 |
| 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 | 98 |
| Number Of Services | 3900 |
| Number Of Medicare Beneficiaries | 656 |
| Total Submitted Charge Amount | 283179.22 |
| Total Medicare Allowed Amount | 206730.64 |
| Total Medicare Payment Amount | 151809.88 |
| Total Medicare Standardized Payment Amount | 156218.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 763 |
| Number Of Medicare Beneficiaries With Drug Services | 153 |
| Total Drug Submitted ChargeAmount | 19191.48 |
| Total Drug Medicare AllowedAmount | 13241.12 |
| Total Drug Medicare PaymentAmount | 11732.17 |
| Total Drug Medicare Standardized Payment Amount | 11732.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 3137 |
| Number Of Medicare Beneficiaries With Medical Services | 656 |
| Total Medical Submitted Charge Amount | 263987.74 |
| Total Medical Medicare Allowed Amount | 193489.52 |
| Total Medical Medicare Payment Amount | 140077.71 |
| Total Medical Medicare Standardized Payment Amount | 144486.11 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 275 |
| Number Of Beneficiaries Age 75 to 84 | 184 |
| Number Of Beneficiaries Age Greater 84 | 130 |
| Number Of Female Beneficiaries | 431 |
| Number Of Male Beneficiaries | 225 |
| Number Of Non Hispanic White Beneficiaries | 616 |
| 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 | 535 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 121 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.12 |