National Provider Identifier [NPI]: |
1861650350 |
Last Name Of The Provider |
JAMISON |
First Name Of The Provider |
SUZANNA |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3 RIVERSIDE CIRCLE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROANOKE |
Zip Code Of The Provider |
24016 |
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 |
22 |
Number Of Services |
531 |
Number Of Medicare Beneficiaries |
208 |
Total Submitted Charge Amount |
60489 |
Total Medicare Allowed Amount |
43489.9 |
Total Medicare Payment Amount |
31807.13 |
Total Medicare Standardized Payment Amount |
33405.04 |
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 |
22 |
Number Of Medical Services |
531 |
Number Of Medicare Beneficiaries With Medical Services |
208 |
Total Medical Submitted Charge Amount |
60489 |
Total Medical Medicare Allowed Amount |
43489.9 |
Total Medical Medicare Payment Amount |
31807.13 |
Total Medical Medicare Standardized Payment Amount |
33405.04 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
142 |
Number Of Male Beneficiaries |
66 |
Number Of Non Hispanic White Beneficiaries |
173 |
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 |
113 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
95 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
56 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.8524 |