National Provider Identifier [NPI]: |
1649481730 |
Last Name Of The Provider |
BOONE |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1314 PETERS CREEK RD NW |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROANOKE |
Zip Code Of The Provider |
240172500 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
1981 |
Number Of Medicare Beneficiaries |
287 |
Total Submitted Charge Amount |
150506 |
Total Medicare Allowed Amount |
106874.23 |
Total Medicare Payment Amount |
78653.19 |
Total Medicare Standardized Payment Amount |
80784.07 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
171 |
Number Of Medicare Beneficiaries With Drug Services |
128 |
Total Drug Submitted ChargeAmount |
5020 |
Total Drug Medicare AllowedAmount |
3973.7 |
Total Drug Medicare PaymentAmount |
3866.62 |
Total Drug Medicare Standardized Payment Amount |
3866.62 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
1810 |
Number Of Medicare Beneficiaries With Medical Services |
287 |
Total Medical Submitted Charge Amount |
145486 |
Total Medical Medicare Allowed Amount |
102900.53 |
Total Medical Medicare Payment Amount |
74786.57 |
Total Medical Medicare Standardized Payment Amount |
76917.45 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
137 |
Number Of Beneficiaries Age 75 to 84 |
83 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
167 |
Number Of Male Beneficiaries |
120 |
Number Of Non Hispanic White Beneficiaries |
274 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
261 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8828 |