National Provider Identifier [NPI]: |
1902806714 |
Last Name Of The Provider |
VIVES |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1860 TOWN CENTER DR |
Street Address 2 Of The Provider |
#120 |
City Of The Provider |
RESTON |
Zip Code Of The Provider |
201905896 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
3775 |
Number Of Medicare Beneficiaries |
1807 |
Total Submitted Charge Amount |
977596.06 |
Total Medicare Allowed Amount |
452833.44 |
Total Medicare Payment Amount |
339803.22 |
Total Medicare Standardized Payment Amount |
303192.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
358 |
Number Of Medicare Beneficiaries With Drug Services |
90 |
Total Drug Submitted ChargeAmount |
18530.06 |
Total Drug Medicare AllowedAmount |
18452.25 |
Total Drug Medicare PaymentAmount |
14145.74 |
Total Drug Medicare Standardized Payment Amount |
14145.74 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
3417 |
Number Of Medicare Beneficiaries With Medical Services |
1807 |
Total Medical Submitted Charge Amount |
959066 |
Total Medical Medicare Allowed Amount |
434381.19 |
Total Medical Medicare Payment Amount |
325657.48 |
Total Medical Medicare Standardized Payment Amount |
289046.63 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
125 |
Number Of Beneficiaries Age 65 to 74 |
717 |
Number Of Beneficiaries Age 75 to 84 |
607 |
Number Of Beneficiaries Age Greater 84 |
358 |
Number Of Female Beneficiaries |
877 |
Number Of Male Beneficiaries |
930 |
Number Of Non Hispanic White Beneficiaries |
1347 |
Number Of Black or African American Beneficiaries |
132 |
Number Of AsianPacific Islander Beneficiaries |
155 |
Number Of Hispanic Beneficiaries |
124 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1551 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
256 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.5841 |