National Provider Identifier [NPI]: |
1386690428 |
Last Name Of The Provider |
GOLOVKINA-HYNES |
First Name Of The Provider |
ALLA |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
755 S MAIN ST |
Street Address 2 Of The Provider |
SUITE B01 |
City Of The Provider |
WOODSTOCK |
Zip Code Of The Provider |
22664 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
1174 |
Number Of Medicare Beneficiaries |
427 |
Total Submitted Charge Amount |
342536 |
Total Medicare Allowed Amount |
138312.11 |
Total Medicare Payment Amount |
100120.83 |
Total Medicare Standardized Payment Amount |
104540.95 |
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 |
32 |
Number Of Medical Services |
1174 |
Number Of Medicare Beneficiaries With Medical Services |
427 |
Total Medical Submitted Charge Amount |
342536 |
Total Medical Medicare Allowed Amount |
138312.11 |
Total Medical Medicare Payment Amount |
100120.83 |
Total Medical Medicare Standardized Payment Amount |
104540.95 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
202 |
Number Of Beneficiaries Age 75 to 84 |
140 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
233 |
Number Of Male Beneficiaries |
194 |
Number Of Non Hispanic White Beneficiaries |
414 |
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 |
386 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0195 |