| National Provider Identifier [NPI]: | 1679542815 |
| Last Name Of The Provider | MCKENNA |
| First Name Of The Provider | VIRGINIA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1821 S STOUGHTON RD |
| Street Address 2 Of The Provider | DEAN MEDICAL CENTER |
| City Of The Provider | MADISON |
| Zip Code Of The Provider | 537162257 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 968 |
| Number Of Medicare Beneficiaries | 115 |
| Total Submitted Charge Amount | 109068.98 |
| Total Medicare Allowed Amount | 29082.7 |
| Total Medicare Payment Amount | 23456.82 |
| Total Medicare Standardized Payment Amount | 24200.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 202 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 3120 |
| Total Drug Medicare AllowedAmount | 1475.35 |
| Total Drug Medicare PaymentAmount | 1405.45 |
| Total Drug Medicare Standardized Payment Amount | 1405.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 766 |
| Number Of Medicare Beneficiaries With Medical Services | 115 |
| Total Medical Submitted Charge Amount | 105948.98 |
| Total Medical Medicare Allowed Amount | 27607.35 |
| Total Medical Medicare Payment Amount | 22051.37 |
| Total Medical Medicare Standardized Payment Amount | 22795.38 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 54 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 98 |
| Number Of Male Beneficiaries | 17 |
| Number Of Non Hispanic White Beneficiaries | 102 |
| 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 | 88 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| 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 | 28 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 41 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8064 |