National Provider Identifier [NPI]: |
1841200607 |
Last Name Of The Provider |
DAY |
First Name Of The Provider |
WINDLE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1975 GLENN MITCHELL DR |
Street Address 2 Of The Provider |
STE 202 |
City Of The Provider |
VIRGINIA BEACH |
Zip Code Of The Provider |
234560167 |
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 |
54 |
Number Of Services |
586 |
Number Of Medicare Beneficiaries |
237 |
Total Submitted Charge Amount |
56323 |
Total Medicare Allowed Amount |
21919.47 |
Total Medicare Payment Amount |
16169.96 |
Total Medicare Standardized Payment Amount |
19904.12 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
31 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
346 |
Total Drug Medicare AllowedAmount |
166.56 |
Total Drug Medicare PaymentAmount |
155.92 |
Total Drug Medicare Standardized Payment Amount |
155.92 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
555 |
Number Of Medicare Beneficiaries With Medical Services |
237 |
Total Medical Submitted Charge Amount |
55977 |
Total Medical Medicare Allowed Amount |
21752.91 |
Total Medical Medicare Payment Amount |
16014.04 |
Total Medical Medicare Standardized Payment Amount |
19748.2 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
155 |
Number Of Male Beneficiaries |
82 |
Number Of Non Hispanic White Beneficiaries |
150 |
Number Of Black or African American Beneficiaries |
66 |
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 |
218 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0493 |