National Provider Identifier [NPI]: |
1205889474 |
Last Name Of The Provider |
HEWITT |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1001 SAM PERRY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
FREDERICKSBURG |
Zip Code Of The Provider |
224014453 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
116 |
Number Of Services |
5407 |
Number Of Medicare Beneficiaries |
2878 |
Total Submitted Charge Amount |
905899 |
Total Medicare Allowed Amount |
234190.65 |
Total Medicare Payment Amount |
189652.72 |
Total Medicare Standardized Payment Amount |
195338.61 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
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Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
338 |
Number Of Beneficiaries Age 65 to 74 |
1284 |
Number Of Beneficiaries Age 75 to 84 |
857 |
Number Of Beneficiaries Age Greater 84 |
399 |
Number Of Female Beneficiaries |
2037 |
Number Of Male Beneficiaries |
841 |
Number Of Non Hispanic White Beneficiaries |
2309 |
Number Of Black or African American Beneficiaries |
438 |
Number Of AsianPacific Islander Beneficiaries |
42 |
Number Of Hispanic Beneficiaries |
53 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
36 |
Number Of Beneficiaries With Medicare Only Entitlement |
2458 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
420 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.4697 |