National Provider Identifier [NPI]: |
1861495871 |
Last Name Of The Provider |
REX |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8101 HINSON FARM RD |
Street Address 2 Of The Provider |
STE 415 |
City Of The Provider |
ALEXANDRIA |
Zip Code Of The Provider |
223063410 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
728 |
Number Of Medicare Beneficiaries |
239 |
Total Submitted Charge Amount |
86990 |
Total Medicare Allowed Amount |
64508.05 |
Total Medicare Payment Amount |
51496.91 |
Total Medicare Standardized Payment Amount |
46185.92 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
51 |
Number Of Medicare Beneficiaries With Drug Services |
42 |
Total Drug Submitted ChargeAmount |
1400 |
Total Drug Medicare AllowedAmount |
717.05 |
Total Drug Medicare PaymentAmount |
698.8 |
Total Drug Medicare Standardized Payment Amount |
698.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
677 |
Number Of Medicare Beneficiaries With Medical Services |
239 |
Total Medical Submitted Charge Amount |
85590 |
Total Medical Medicare Allowed Amount |
63791 |
Total Medical Medicare Payment Amount |
50798.11 |
Total Medical Medicare Standardized Payment Amount |
45487.12 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
105 |
Number Of Beneficiaries Age 75 to 84 |
89 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
121 |
Number Of Male Beneficiaries |
118 |
Number Of Non Hispanic White Beneficiaries |
220 |
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
8 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
10 |
Percent Of With Diabetes |
15 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
37 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.8315 |