National Provider Identifier [NPI]: |
1093780223 |
Last Name Of The Provider |
BRISLAND |
First Name Of The Provider |
CATHERINE |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 GRESHAM DR |
Street Address 2 Of The Provider |
RALEIGH BLVD 3RD FL |
City Of The Provider |
NORFOLK |
Zip Code Of The Provider |
235071904 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
1656 |
Number Of Medicare Beneficiaries |
494 |
Total Submitted Charge Amount |
246388.99 |
Total Medicare Allowed Amount |
148327.63 |
Total Medicare Payment Amount |
114551.17 |
Total Medicare Standardized Payment Amount |
116744.21 |
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 |
18 |
Number Of Medical Services |
1656 |
Number Of Medicare Beneficiaries With Medical Services |
494 |
Total Medical Submitted Charge Amount |
246388.99 |
Total Medical Medicare Allowed Amount |
148327.63 |
Total Medical Medicare Payment Amount |
114551.17 |
Total Medical Medicare Standardized Payment Amount |
116744.21 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
114 |
Number Of Beneficiaries Age 65 to 74 |
166 |
Number Of Beneficiaries Age 75 to 84 |
138 |
Number Of Beneficiaries Age Greater 84 |
76 |
Number Of Female Beneficiaries |
239 |
Number Of Male Beneficiaries |
255 |
Number Of Non Hispanic White Beneficiaries |
298 |
Number Of Black or African American Beneficiaries |
171 |
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 |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
374 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
120 |
Percent Of With Atrial Fibrillation |
33 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
63 |
Percent Of With Chronic Kidney Disease |
64 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.4765 |