National Provider Identifier [NPI]: |
1215997325 |
Last Name Of The Provider |
AINSWORTH |
First Name Of The Provider |
MAKINI |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4604 SPOTSYLVANIA PKWY |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
FREDERICKSBURG |
Zip Code Of The Provider |
224087763 |
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 |
34 |
Number Of Services |
925 |
Number Of Medicare Beneficiaries |
187 |
Total Submitted Charge Amount |
179418 |
Total Medicare Allowed Amount |
75353.66 |
Total Medicare Payment Amount |
54502.59 |
Total Medicare Standardized Payment Amount |
55948.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
89 |
Number Of Medicare Beneficiaries With Drug Services |
63 |
Total Drug Submitted ChargeAmount |
7928 |
Total Drug Medicare AllowedAmount |
2909.19 |
Total Drug Medicare PaymentAmount |
2826.99 |
Total Drug Medicare Standardized Payment Amount |
2826.99 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
836 |
Number Of Medicare Beneficiaries With Medical Services |
187 |
Total Medical Submitted Charge Amount |
171490 |
Total Medical Medicare Allowed Amount |
72444.47 |
Total Medical Medicare Payment Amount |
51675.6 |
Total Medical Medicare Standardized Payment Amount |
53121.91 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
144 |
Number Of Male Beneficiaries |
43 |
Number Of Non Hispanic White Beneficiaries |
120 |
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 |
138 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2139 |