National Provider Identifier [NPI]: |
1639330046 |
Last Name Of The Provider |
LAWRENCE |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
LEE ST FL 1 |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHARLOTTESVILLE |
Zip Code Of The Provider |
229080001 |
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 |
120 |
Number Of Services |
4220 |
Number Of Medicare Beneficiaries |
1670 |
Total Submitted Charge Amount |
1894679.46 |
Total Medicare Allowed Amount |
301324.65 |
Total Medicare Payment Amount |
227898.07 |
Total Medicare Standardized Payment Amount |
218803.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
1228 |
Number Of Medicare Beneficiaries With Drug Services |
137 |
Total Drug Submitted ChargeAmount |
5759.36 |
Total Drug Medicare AllowedAmount |
1976.72 |
Total Drug Medicare PaymentAmount |
1463.44 |
Total Drug Medicare Standardized Payment Amount |
1463.44 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
114 |
Number Of Medical Services |
2992 |
Number Of Medicare Beneficiaries With Medical Services |
1668 |
Total Medical Submitted Charge Amount |
1888920.1 |
Total Medical Medicare Allowed Amount |
299347.93 |
Total Medical Medicare Payment Amount |
226434.63 |
Total Medical Medicare Standardized Payment Amount |
217340.21 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
367 |
Number Of Beneficiaries Age 65 to 74 |
707 |
Number Of Beneficiaries Age 75 to 84 |
459 |
Number Of Beneficiaries Age Greater 84 |
137 |
Number Of Female Beneficiaries |
1022 |
Number Of Male Beneficiaries |
648 |
Number Of Non Hispanic White Beneficiaries |
1332 |
Number Of Black or African American Beneficiaries |
264 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
27 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
31 |
Number Of Beneficiaries With Medicare Only Entitlement |
1296 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
374 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
73 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2657 |