National Provider Identifier [NPI]: |
1720371362 |
Last Name Of The Provider |
HARRELL |
First Name Of The Provider |
AMANDA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5801 BREMO RD., 2ND FLOOR |
Street Address 2 Of The Provider |
|
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
23226 |
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 |
13 |
Number Of Services |
346 |
Number Of Medicare Beneficiaries |
130 |
Total Submitted Charge Amount |
40351.87 |
Total Medicare Allowed Amount |
26900.52 |
Total Medicare Payment Amount |
21089.5 |
Total Medicare Standardized Payment Amount |
21401.9 |
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 |
13 |
Number Of Medical Services |
346 |
Number Of Medicare Beneficiaries With Medical Services |
130 |
Total Medical Submitted Charge Amount |
40351.87 |
Total Medical Medicare Allowed Amount |
26900.52 |
Total Medical Medicare Payment Amount |
21089.5 |
Total Medical Medicare Standardized Payment Amount |
21401.9 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
31 |
Number Of Beneficiaries Age 75 to 84 |
34 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
77 |
Number Of Male Beneficiaries |
53 |
Number Of Non Hispanic White Beneficiaries |
91 |
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 |
96 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
39 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.4727 |