National Provider Identifier [NPI]: |
1477504603 |
Last Name Of The Provider |
HOLLIS |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1211 RODMAN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORTSMOUTH |
Zip Code Of The Provider |
237073915 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
1262 |
Number Of Medicare Beneficiaries |
611 |
Total Submitted Charge Amount |
331400 |
Total Medicare Allowed Amount |
158588.29 |
Total Medicare Payment Amount |
115058.55 |
Total Medicare Standardized Payment Amount |
118512.24 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
286 |
Number Of Beneficiaries Age 75 to 84 |
170 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
354 |
Number Of Male Beneficiaries |
257 |
Number Of Non Hispanic White Beneficiaries |
225 |
Number Of Black or African American Beneficiaries |
365 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
499 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
112 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2165 |