National Provider Identifier [NPI]: |
1932405479 |
Last Name Of The Provider |
MODY |
First Name Of The Provider |
NEHA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
P.A. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1651 N PARHAM RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
232294605 |
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 |
21 |
Number Of Services |
238 |
Number Of Medicare Beneficiaries |
214 |
Total Submitted Charge Amount |
72050 |
Total Medicare Allowed Amount |
19955.59 |
Total Medicare Payment Amount |
15194.79 |
Total Medicare Standardized Payment Amount |
18368.89 |
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 |
21 |
Number Of Medical Services |
238 |
Number Of Medicare Beneficiaries With Medical Services |
214 |
Total Medical Submitted Charge Amount |
72050 |
Total Medical Medicare Allowed Amount |
19955.59 |
Total Medical Medicare Payment Amount |
15194.79 |
Total Medical Medicare Standardized Payment Amount |
18368.89 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
114 |
Number Of Male Beneficiaries |
100 |
Number Of Non Hispanic White Beneficiaries |
156 |
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 |
160 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.352 |