National Provider Identifier [NPI]: |
1083709539 |
Last Name Of The Provider |
KOMOROWSKI |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1250 E MARSHALL STREET |
Street Address 2 Of The Provider |
RADIOLOGY |
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
232980470 |
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 |
142 |
Number Of Services |
1082 |
Number Of Medicare Beneficiaries |
420 |
Total Submitted Charge Amount |
2968368 |
Total Medicare Allowed Amount |
143087.41 |
Total Medicare Payment Amount |
108475.19 |
Total Medicare Standardized Payment Amount |
114518.7 |
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 |
142 |
Number Of Medical Services |
1082 |
Number Of Medicare Beneficiaries With Medical Services |
420 |
Total Medical Submitted Charge Amount |
2968368 |
Total Medical Medicare Allowed Amount |
143087.41 |
Total Medical Medicare Payment Amount |
108475.19 |
Total Medical Medicare Standardized Payment Amount |
114518.7 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
197 |
Number Of Beneficiaries Age 65 to 74 |
153 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
188 |
Number Of Male Beneficiaries |
232 |
Number Of Non Hispanic White Beneficiaries |
185 |
Number Of Black or African American Beneficiaries |
217 |
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 |
230 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
190 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
74 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
4.3743 |