National Provider Identifier [NPI]: |
1992789093 |
Last Name Of The Provider |
DORSAY |
First Name Of The Provider |
THEODORE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5544 GREENWICH RD STE 200 |
Street Address 2 Of The Provider |
|
City Of The Provider |
VIRGINIA BEACH |
Zip Code Of The Provider |
234626563 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
144 |
Number Of Services |
4341 |
Number Of Medicare Beneficiaries |
3397 |
Total Submitted Charge Amount |
524999 |
Total Medicare Allowed Amount |
142064.37 |
Total Medicare Payment Amount |
105876.39 |
Total Medicare Standardized Payment Amount |
108828.44 |
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 |
144 |
Number Of Medical Services |
4341 |
Number Of Medicare Beneficiaries With Medical Services |
3397 |
Total Medical Submitted Charge Amount |
524999 |
Total Medical Medicare Allowed Amount |
142064.37 |
Total Medical Medicare Payment Amount |
105876.39 |
Total Medical Medicare Standardized Payment Amount |
108828.44 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
685 |
Number Of Beneficiaries Age 65 to 74 |
1310 |
Number Of Beneficiaries Age 75 to 84 |
926 |
Number Of Beneficiaries Age Greater 84 |
476 |
Number Of Female Beneficiaries |
1999 |
Number Of Male Beneficiaries |
1398 |
Number Of Non Hispanic White Beneficiaries |
2151 |
Number Of Black or African American Beneficiaries |
1092 |
Number Of AsianPacific Islander Beneficiaries |
48 |
Number Of Hispanic Beneficiaries |
61 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
2678 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
719 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.7814 |