| National Provider Identifier [NPI]: | 1427051390 |
| Last Name Of The Provider | HEAVNER |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 GRAND CENTRAL MALL |
| Street Address 2 Of The Provider | SUITE 4 |
| City Of The Provider | VIENNA |
| Zip Code Of The Provider | 261054131 |
| State Code Of The Provider | WV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 180 |
| Number Of Services | 29014 |
| Number Of Medicare Beneficiaries | 2418 |
| Total Submitted Charge Amount | 1922572.17 |
| Total Medicare Allowed Amount | 566483.42 |
| Total Medicare Payment Amount | 469558.6 |
| Total Medicare Standardized Payment Amount | 502376.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 537 |
| Number Of Medicare Beneficiaries With Drug Services | 334 |
| Total Drug Submitted ChargeAmount | 20831 |
| Total Drug Medicare AllowedAmount | 12385.28 |
| Total Drug Medicare PaymentAmount | 11066.59 |
| Total Drug Medicare Standardized Payment Amount | 11066.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 167 |
| Number Of Medical Services | 28477 |
| Number Of Medicare Beneficiaries With Medical Services | 2418 |
| Total Medical Submitted Charge Amount | 1901741.17 |
| Total Medical Medicare Allowed Amount | 554098.14 |
| Total Medical Medicare Payment Amount | 458492.01 |
| Total Medical Medicare Standardized Payment Amount | 491309.62 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 468 |
| Number Of Beneficiaries Age 65 to 74 | 1043 |
| Number Of Beneficiaries Age 75 to 84 | 708 |
| Number Of Beneficiaries Age Greater 84 | 199 |
| Number Of Female Beneficiaries | 1259 |
| Number Of Male Beneficiaries | 1159 |
| Number Of Non Hispanic White Beneficiaries | 2368 |
| 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 | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1984 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 434 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2036 |