National Provider Identifier [NPI]: |
1124098314 |
Last Name Of The Provider |
KILLEEN |
First Name Of The Provider |
KAREN |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1508 WILLOW LAWN DR |
Street Address 2 Of The Provider |
STE 117 |
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
232303421 |
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 |
147 |
Number Of Services |
8206 |
Number Of Medicare Beneficiaries |
5660 |
Total Submitted Charge Amount |
695470 |
Total Medicare Allowed Amount |
261884.47 |
Total Medicare Payment Amount |
192552.71 |
Total Medicare Standardized Payment Amount |
199501.61 |
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 |
147 |
Number Of Medical Services |
8206 |
Number Of Medicare Beneficiaries With Medical Services |
5660 |
Total Medical Submitted Charge Amount |
695470 |
Total Medical Medicare Allowed Amount |
261884.47 |
Total Medical Medicare Payment Amount |
192552.71 |
Total Medical Medicare Standardized Payment Amount |
199501.61 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
860 |
Number Of Beneficiaries Age 65 to 74 |
1985 |
Number Of Beneficiaries Age 75 to 84 |
1672 |
Number Of Beneficiaries Age Greater 84 |
1143 |
Number Of Female Beneficiaries |
3491 |
Number Of Male Beneficiaries |
2169 |
Number Of Non Hispanic White Beneficiaries |
3928 |
Number Of Black or African American Beneficiaries |
1576 |
Number Of AsianPacific Islander Beneficiaries |
56 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
50 |
Number Of Beneficiaries With Medicare Only Entitlement |
4518 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1142 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.7481 |