National Provider Identifier [NPI]: |
1205835725 |
Last Name Of The Provider |
AGADA |
First Name Of The Provider |
RAPHAEL |
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 |
801 S ADAMS ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PETERSBURG |
Zip Code Of The Provider |
238035149 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
7881 |
Number Of Medicare Beneficiaries |
960 |
Total Submitted Charge Amount |
1156222.15 |
Total Medicare Allowed Amount |
672495.05 |
Total Medicare Payment Amount |
523346.52 |
Total Medicare Standardized Payment Amount |
531931.83 |
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 |
38 |
Number Of Medical Services |
7881 |
Number Of Medicare Beneficiaries With Medical Services |
960 |
Total Medical Submitted Charge Amount |
1156222.15 |
Total Medical Medicare Allowed Amount |
672495.05 |
Total Medical Medicare Payment Amount |
523346.52 |
Total Medical Medicare Standardized Payment Amount |
531931.83 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
199 |
Number Of Beneficiaries Age 65 to 74 |
282 |
Number Of Beneficiaries Age 75 to 84 |
278 |
Number Of Beneficiaries Age Greater 84 |
201 |
Number Of Female Beneficiaries |
537 |
Number Of Male Beneficiaries |
423 |
Number Of Non Hispanic White Beneficiaries |
511 |
Number Of Black or African American Beneficiaries |
426 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
587 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
373 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
2.4209 |