| National Provider Identifier [NPI]: | 1043309107 |
| Last Name Of The Provider | DAFFERN |
| First Name Of The Provider | PAMELA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7489 RIGHT FLANK RD |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | MECHANICSVILLE |
| Zip Code Of The Provider | 231163845 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 16035 |
| Number Of Medicare Beneficiaries | 362 |
| Total Submitted Charge Amount | 753902.86 |
| Total Medicare Allowed Amount | 261202.87 |
| Total Medicare Payment Amount | 204652.38 |
| Total Medicare Standardized Payment Amount | 206715.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 10843 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 480786.81 |
| Total Drug Medicare AllowedAmount | 177072.53 |
| Total Drug Medicare PaymentAmount | 138827.47 |
| Total Drug Medicare Standardized Payment Amount | 138827.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 5192 |
| Number Of Medicare Beneficiaries With Medical Services | 362 |
| Total Medical Submitted Charge Amount | 273116.05 |
| Total Medical Medicare Allowed Amount | 84130.34 |
| Total Medical Medicare Payment Amount | 65824.91 |
| Total Medical Medicare Standardized Payment Amount | 67888.05 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 212 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 230 |
| Number Of Male Beneficiaries | 132 |
| Number Of Non Hispanic White Beneficiaries | 299 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 327 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 34 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7921 |