National Provider Identifier [NPI]: |
1457557001 |
Last Name Of The Provider |
NAIRN |
First Name Of The Provider |
TODD |
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 |
617 CAMPUS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ABINGDON |
Zip Code Of The Provider |
242109700 |
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 |
39 |
Number Of Services |
1740 |
Number Of Medicare Beneficiaries |
320 |
Total Submitted Charge Amount |
192420 |
Total Medicare Allowed Amount |
93936.18 |
Total Medicare Payment Amount |
68584.75 |
Total Medicare Standardized Payment Amount |
70064.04 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
334 |
Number Of Medicare Beneficiaries With Drug Services |
150 |
Total Drug Submitted ChargeAmount |
8703 |
Total Drug Medicare AllowedAmount |
5066.77 |
Total Drug Medicare PaymentAmount |
4822.5 |
Total Drug Medicare Standardized Payment Amount |
4822.5 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
1406 |
Number Of Medicare Beneficiaries With Medical Services |
320 |
Total Medical Submitted Charge Amount |
183717 |
Total Medical Medicare Allowed Amount |
88869.41 |
Total Medical Medicare Payment Amount |
63762.25 |
Total Medical Medicare Standardized Payment Amount |
65241.54 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
67 |
Number Of Beneficiaries Age 65 to 74 |
161 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
134 |
Number Of Male Beneficiaries |
186 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
289 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.8815 |