National Provider Identifier [NPI]: |
1043284672 |
Last Name Of The Provider |
SMITHSON |
First Name Of The Provider |
LORI |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1508 WILLOW LAWN DR |
Street Address 2 Of The Provider |
STE 117 |
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
232303421 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
139 |
Number Of Services |
3931 |
Number Of Medicare Beneficiaries |
2714 |
Total Submitted Charge Amount |
441530 |
Total Medicare Allowed Amount |
167149.49 |
Total Medicare Payment Amount |
123647.16 |
Total Medicare Standardized Payment Amount |
129581.73 |
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 |
139 |
Number Of Medical Services |
3931 |
Number Of Medicare Beneficiaries With Medical Services |
2714 |
Total Medical Submitted Charge Amount |
441530 |
Total Medical Medicare Allowed Amount |
167149.49 |
Total Medical Medicare Payment Amount |
123647.16 |
Total Medical Medicare Standardized Payment Amount |
129581.73 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
381 |
Number Of Beneficiaries Age 65 to 74 |
1070 |
Number Of Beneficiaries Age 75 to 84 |
802 |
Number Of Beneficiaries Age Greater 84 |
461 |
Number Of Female Beneficiaries |
1705 |
Number Of Male Beneficiaries |
1009 |
Number Of Non Hispanic White Beneficiaries |
1972 |
Number Of Black or African American Beneficiaries |
664 |
Number Of AsianPacific Islander Beneficiaries |
26 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
24 |
Number Of Beneficiaries With Medicare Only Entitlement |
2268 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
446 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.6213 |