National Provider Identifier [NPI]: |
1336160837 |
Last Name Of The Provider |
COO |
First Name Of The Provider |
ALBERT |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6300 STEVENSON AVE |
Street Address 2 Of The Provider |
SUITE D |
City Of The Provider |
ALEXANDRIA |
Zip Code Of The Provider |
223043576 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
3568 |
Number Of Medicare Beneficiaries |
492 |
Total Submitted Charge Amount |
380407 |
Total Medicare Allowed Amount |
160046.19 |
Total Medicare Payment Amount |
115851 |
Total Medicare Standardized Payment Amount |
108702.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
404 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
55052 |
Total Drug Medicare AllowedAmount |
24520.99 |
Total Drug Medicare PaymentAmount |
19226.16 |
Total Drug Medicare Standardized Payment Amount |
19226.16 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
3164 |
Number Of Medicare Beneficiaries With Medical Services |
492 |
Total Medical Submitted Charge Amount |
325355 |
Total Medical Medicare Allowed Amount |
135525.2 |
Total Medical Medicare Payment Amount |
96624.84 |
Total Medical Medicare Standardized Payment Amount |
89476.44 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
231 |
Number Of Beneficiaries Age 75 to 84 |
168 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
292 |
Number Of Male Beneficiaries |
200 |
Number Of Non Hispanic White Beneficiaries |
330 |
Number Of Black or African American Beneficiaries |
83 |
Number Of AsianPacific Islander Beneficiaries |
40 |
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
450 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5377 |