National Provider Identifier [NPI]: |
1215934906 |
Last Name Of The Provider |
KEYS-FREZZELL |
First Name Of The Provider |
DANA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
850 KEMPSVILLE RD |
Street Address 2 Of The Provider |
STE 200A |
City Of The Provider |
NORFOLK |
Zip Code Of The Provider |
235023920 |
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 |
29 |
Number Of Services |
1504 |
Number Of Medicare Beneficiaries |
508 |
Total Submitted Charge Amount |
199909 |
Total Medicare Allowed Amount |
103405.9 |
Total Medicare Payment Amount |
80705.47 |
Total Medicare Standardized Payment Amount |
82662.24 |
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 |
29 |
Number Of Medical Services |
1504 |
Number Of Medicare Beneficiaries With Medical Services |
508 |
Total Medical Submitted Charge Amount |
199909 |
Total Medical Medicare Allowed Amount |
103405.9 |
Total Medical Medicare Payment Amount |
80705.47 |
Total Medical Medicare Standardized Payment Amount |
82662.24 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
220 |
Number Of Beneficiaries Age 75 to 84 |
168 |
Number Of Beneficiaries Age Greater 84 |
84 |
Number Of Female Beneficiaries |
368 |
Number Of Male Beneficiaries |
140 |
Number Of Non Hispanic White Beneficiaries |
353 |
Number Of Black or African American Beneficiaries |
135 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
478 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1351 |