National Provider Identifier [NPI]: |
1962460105 |
Last Name Of The Provider |
DOLANSKY |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
414 MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WARSAW |
Zip Code Of The Provider |
22572 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
343 |
Number Of Medicare Beneficiaries |
160 |
Total Submitted Charge Amount |
24195 |
Total Medicare Allowed Amount |
24161.94 |
Total Medicare Payment Amount |
12202.7 |
Total Medicare Standardized Payment Amount |
17141.83 |
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 |
5 |
Number Of Medical Services |
343 |
Number Of Medicare Beneficiaries With Medical Services |
160 |
Total Medical Submitted Charge Amount |
24195 |
Total Medical Medicare Allowed Amount |
24161.94 |
Total Medical Medicare Payment Amount |
12202.7 |
Total Medical Medicare Standardized Payment Amount |
17141.83 |
Average Age Of Beneficiaries |
51 |
Number Of Beneficiaries Age Less65 |
139 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
90 |
Number Of Male Beneficiaries |
70 |
Number Of Non Hispanic White Beneficiaries |
87 |
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 |
37 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
123 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
34 |
Percent Of With Hypertension |
39 |
Percent Of With Ischemic Heart Disease |
13 |
Percent Of With Osteoporosis |
0 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
21 |
Percent Of With Schizophrenia Other PsychoticDisorders |
42 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1452 |