National Provider Identifier [NPI]: |
1750499968 |
Last Name Of The Provider |
JANA |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1301 RICHMOND ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
STAUNTON |
Zip Code Of The Provider |
24402 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
225.9 |
Number Of Medicare Beneficiaries |
69 |
Total Submitted Charge Amount |
12575.17 |
Total Medicare Allowed Amount |
10147.15 |
Total Medicare Payment Amount |
6898.18 |
Total Medicare Standardized Payment Amount |
7777.41 |
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 |
11 |
Number Of Medical Services |
225.9 |
Number Of Medicare Beneficiaries With Medical Services |
69 |
Total Medical Submitted Charge Amount |
12575.17 |
Total Medical Medicare Allowed Amount |
10147.15 |
Total Medical Medicare Payment Amount |
6898.18 |
Total Medical Medicare Standardized Payment Amount |
7777.41 |
Average Age Of Beneficiaries |
49 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
34 |
Number Of Male Beneficiaries |
35 |
Number Of Non Hispanic White Beneficiaries |
55 |
Number Of Black or African American Beneficiaries |
14 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
12 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
57 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
64 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
30 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
0 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
19 |
Percent Of With Schizophrenia Other PsychoticDisorders |
55 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0614 |