National Provider Identifier [NPI]: |
1881820900 |
Last Name Of The Provider |
DEWITT |
First Name Of The Provider |
PHILIP |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10800 MIDLOTHIAN TPKE |
Street Address 2 Of The Provider |
SUITE 265 |
City Of The Provider |
NORTH CHESTERFIELD |
Zip Code Of The Provider |
232354724 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
570 |
Number Of Medicare Beneficiaries |
460 |
Total Submitted Charge Amount |
481176.04 |
Total Medicare Allowed Amount |
66789.86 |
Total Medicare Payment Amount |
51252.6 |
Total Medicare Standardized Payment Amount |
52799.5 |
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 |
77 |
Number Of Medical Services |
570 |
Number Of Medicare Beneficiaries With Medical Services |
460 |
Total Medical Submitted Charge Amount |
481176.04 |
Total Medical Medicare Allowed Amount |
66789.86 |
Total Medical Medicare Payment Amount |
51252.6 |
Total Medical Medicare Standardized Payment Amount |
52799.5 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
218 |
Number Of Beneficiaries Age 75 to 84 |
151 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
267 |
Number Of Male Beneficiaries |
193 |
Number Of Non Hispanic White Beneficiaries |
379 |
Number Of Black or African American Beneficiaries |
70 |
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 |
415 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2262 |