National Provider Identifier [NPI]: |
1972529626 |
Last Name Of The Provider |
REZBA |
First Name Of The Provider |
BENJAMIN |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1870 AMHERST ST |
Street Address 2 Of The Provider |
SUITE 2D |
City Of The Provider |
WINCHESTER |
Zip Code Of The Provider |
226012841 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
167 |
Number Of Medicare Beneficiaries |
27 |
Total Submitted Charge Amount |
11088.5 |
Total Medicare Allowed Amount |
4569.6 |
Total Medicare Payment Amount |
2912.88 |
Total Medicare Standardized Payment Amount |
3034.69 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
96 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
415 |
Total Drug Medicare AllowedAmount |
173.47 |
Total Drug Medicare PaymentAmount |
124.56 |
Total Drug Medicare Standardized Payment Amount |
124.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
7 |
Number Of Medical Services |
71 |
Number Of Medicare Beneficiaries With Medical Services |
27 |
Total Medical Submitted Charge Amount |
10673.5 |
Total Medical Medicare Allowed Amount |
4396.13 |
Total Medical Medicare Payment Amount |
2788.32 |
Total Medical Medicare Standardized Payment Amount |
2910.13 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
14 |
Number Of Male Beneficiaries |
13 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.93 |