National Provider Identifier [NPI]: |
1093787699 |
Last Name Of The Provider |
NEWSOME |
First Name Of The Provider |
BOBBETTE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1508 WILLOW LAWN DR |
Street Address 2 Of The Provider |
STE 117 |
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
232303421 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
123 |
Number Of Services |
6369 |
Number Of Medicare Beneficiaries |
4200 |
Total Submitted Charge Amount |
408815 |
Total Medicare Allowed Amount |
154793.14 |
Total Medicare Payment Amount |
116340.87 |
Total Medicare Standardized Payment Amount |
121253.12 |
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 |
123 |
Number Of Medical Services |
6369 |
Number Of Medicare Beneficiaries With Medical Services |
4200 |
Total Medical Submitted Charge Amount |
408815 |
Total Medical Medicare Allowed Amount |
154793.14 |
Total Medical Medicare Payment Amount |
116340.87 |
Total Medical Medicare Standardized Payment Amount |
121253.12 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
769 |
Number Of Beneficiaries Age 65 to 74 |
1546 |
Number Of Beneficiaries Age 75 to 84 |
1177 |
Number Of Beneficiaries Age Greater 84 |
708 |
Number Of Female Beneficiaries |
2794 |
Number Of Male Beneficiaries |
1406 |
Number Of Non Hispanic White Beneficiaries |
2646 |
Number Of Black or African American Beneficiaries |
1434 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
34 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
46 |
Number Of Beneficiaries With Medicare Only Entitlement |
3261 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
939 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.6933 |