| National Provider Identifier [NPI]: | 1124108592 |
| Last Name Of The Provider | WAY |
| First Name Of The Provider | DENISE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4916 PLANK RD UNIT 205 |
| Street Address 2 Of The Provider | |
| City Of The Provider | NORTH GARDEN |
| Zip Code Of The Provider | 229591613 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 496 |
| Number Of Medicare Beneficiaries | 73 |
| Total Submitted Charge Amount | 35963.6 |
| Total Medicare Allowed Amount | 20998.84 |
| Total Medicare Payment Amount | 14243.83 |
| Total Medicare Standardized Payment Amount | 15431.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 1128 |
| Total Drug Medicare AllowedAmount | 895.85 |
| Total Drug Medicare PaymentAmount | 870.06 |
| Total Drug Medicare Standardized Payment Amount | 870.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 464 |
| Number Of Medicare Beneficiaries With Medical Services | 73 |
| Total Medical Submitted Charge Amount | 34835.6 |
| Total Medical Medicare Allowed Amount | 20102.99 |
| Total Medical Medicare Payment Amount | 13373.77 |
| Total Medical Medicare Standardized Payment Amount | 14561.68 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 33 |
| Number Of Beneficiaries Age 75 to 84 | 19 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 50 |
| Number Of Male Beneficiaries | 23 |
| Number Of Non Hispanic White Beneficiaries | 55 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1822 |