National Provider Identifier [NPI]: |
1477750834 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
MARCUS |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
245 CHESAPEAKE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEWPORT NEWS |
Zip Code Of The Provider |
236076038 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1665 |
Number Of Medicare Beneficiaries |
490 |
Total Submitted Charge Amount |
227435 |
Total Medicare Allowed Amount |
122196.95 |
Total Medicare Payment Amount |
89695.91 |
Total Medicare Standardized Payment Amount |
88379.19 |
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 |
21 |
Number Of Medical Services |
1665 |
Number Of Medicare Beneficiaries With Medical Services |
490 |
Total Medical Submitted Charge Amount |
227435 |
Total Medical Medicare Allowed Amount |
122196.95 |
Total Medical Medicare Payment Amount |
89695.91 |
Total Medical Medicare Standardized Payment Amount |
88379.19 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
150 |
Number Of Beneficiaries Age 65 to 74 |
160 |
Number Of Beneficiaries Age 75 to 84 |
118 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
291 |
Number Of Male Beneficiaries |
199 |
Number Of Non Hispanic White Beneficiaries |
336 |
Number Of Black or African American Beneficiaries |
138 |
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 |
349 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
141 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
69 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
1.9223 |