National Provider Identifier [NPI]: |
1124277231 |
Last Name Of The Provider |
DAVE |
First Name Of The Provider |
AMITKUMAR |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 N SHENANDOAH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
FRONT ROYAL |
Zip Code Of The Provider |
226303547 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
499 |
Number Of Medicare Beneficiaries |
294 |
Total Submitted Charge Amount |
159043 |
Total Medicare Allowed Amount |
75206.74 |
Total Medicare Payment Amount |
58682 |
Total Medicare Standardized Payment Amount |
59816.89 |
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 |
13 |
Number Of Medical Services |
499 |
Number Of Medicare Beneficiaries With Medical Services |
294 |
Total Medical Submitted Charge Amount |
159043 |
Total Medical Medicare Allowed Amount |
75206.74 |
Total Medical Medicare Payment Amount |
58682 |
Total Medical Medicare Standardized Payment Amount |
59816.89 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
179 |
Number Of Male Beneficiaries |
115 |
Number Of Non Hispanic White Beneficiaries |
227 |
Number Of Black or African American Beneficiaries |
40 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
210 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
1.8762 |