National Provider Identifier [NPI]: |
1326081902 |
Last Name Of The Provider |
HORN |
First Name Of The Provider |
MARILEE |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7650 E PARHAM RD |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
232944373 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
315 |
Number Of Medicare Beneficiaries |
110 |
Total Submitted Charge Amount |
30143 |
Total Medicare Allowed Amount |
12547.14 |
Total Medicare Payment Amount |
9446.19 |
Total Medicare Standardized Payment Amount |
11365.85 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
101 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
707 |
Total Drug Medicare AllowedAmount |
574.75 |
Total Drug Medicare PaymentAmount |
437.47 |
Total Drug Medicare Standardized Payment Amount |
437.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
214 |
Number Of Medicare Beneficiaries With Medical Services |
110 |
Total Medical Submitted Charge Amount |
29436 |
Total Medical Medicare Allowed Amount |
11972.39 |
Total Medical Medicare Payment Amount |
9008.72 |
Total Medical Medicare Standardized Payment Amount |
10928.38 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
56 |
Number Of Beneficiaries Age 75 to 84 |
29 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
31 |
Number Of Non Hispanic White Beneficiaries |
96 |
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9563 |