National Provider Identifier [NPI]: |
1093977571 |
Last Name Of The Provider |
BERRY |
First Name Of The Provider |
TODD |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1250 E MARSHALL ST |
Street Address 2 Of The Provider |
RADIOLOGY |
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
232985051 |
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 |
174 |
Number Of Services |
3423 |
Number Of Medicare Beneficiaries |
2348 |
Total Submitted Charge Amount |
334140 |
Total Medicare Allowed Amount |
88638.94 |
Total Medicare Payment Amount |
69727.29 |
Total Medicare Standardized Payment Amount |
71935.13 |
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 |
174 |
Number Of Medical Services |
3423 |
Number Of Medicare Beneficiaries With Medical Services |
2348 |
Total Medical Submitted Charge Amount |
334140 |
Total Medical Medicare Allowed Amount |
88638.94 |
Total Medical Medicare Payment Amount |
69727.29 |
Total Medical Medicare Standardized Payment Amount |
71935.13 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
496 |
Number Of Beneficiaries Age 65 to 74 |
887 |
Number Of Beneficiaries Age 75 to 84 |
619 |
Number Of Beneficiaries Age Greater 84 |
346 |
Number Of Female Beneficiaries |
1569 |
Number Of Male Beneficiaries |
779 |
Number Of Non Hispanic White Beneficiaries |
1564 |
Number Of Black or African American Beneficiaries |
675 |
Number Of AsianPacific Islander Beneficiaries |
32 |
Number Of Hispanic Beneficiaries |
47 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1828 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
520 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.7022 |