National Provider Identifier [NPI]: |
1851399901 |
Last Name Of The Provider |
TEULE-HEKIMA |
First Name Of The Provider |
NZINGA |
Middle Initial Of The Provider |
Z |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
416 J CLYDE MORRIS BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEWPORT NEWS |
Zip Code Of The Provider |
236011927 |
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 |
11 |
Number Of Services |
512 |
Number Of Medicare Beneficiaries |
162 |
Total Submitted Charge Amount |
25031.94 |
Total Medicare Allowed Amount |
24874.38 |
Total Medicare Payment Amount |
24329.14 |
Total Medicare Standardized Payment Amount |
24440.32 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
254 |
Number Of Medicare Beneficiaries With Drug Services |
158 |
Total Drug Submitted ChargeAmount |
18719.22 |
Total Drug Medicare AllowedAmount |
18562.35 |
Total Drug Medicare PaymentAmount |
18190.94 |
Total Drug Medicare Standardized Payment Amount |
18190.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
6 |
Number Of Medical Services |
258 |
Number Of Medicare Beneficiaries With Medical Services |
161 |
Total Medical Submitted Charge Amount |
6312.72 |
Total Medical Medicare Allowed Amount |
6312.03 |
Total Medical Medicare Payment Amount |
6138.2 |
Total Medical Medicare Standardized Payment Amount |
6249.38 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
56 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
98 |
Number Of Male Beneficiaries |
64 |
Number Of Non Hispanic White Beneficiaries |
97 |
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 |
148 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
7 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7714 |