National Provider Identifier [NPI]: |
1649224643 |
Last Name Of The Provider |
MASTERSON |
First Name Of The Provider |
THOMAS |
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 |
1313 DOLLEY MADISON BLVD |
Street Address 2 Of The Provider |
SUITE 302 |
City Of The Provider |
MC LEAN |
Zip Code Of The Provider |
221013953 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
395 |
Number Of Medicare Beneficiaries |
258 |
Total Submitted Charge Amount |
73860 |
Total Medicare Allowed Amount |
35619.91 |
Total Medicare Payment Amount |
27879.59 |
Total Medicare Standardized Payment Amount |
25866.66 |
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 |
15 |
Number Of Medical Services |
395 |
Number Of Medicare Beneficiaries With Medical Services |
258 |
Total Medical Submitted Charge Amount |
73860 |
Total Medical Medicare Allowed Amount |
35619.91 |
Total Medical Medicare Payment Amount |
27879.59 |
Total Medical Medicare Standardized Payment Amount |
25866.66 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
141 |
Number Of Male Beneficiaries |
117 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
178 |
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 |
179 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
68 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.8978 |