National Provider Identifier [NPI]: |
1235109653 |
Last Name Of The Provider |
MERRILL |
First Name Of The Provider |
LISA |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 SENTARA CIR |
Street Address 2 Of The Provider |
ROOM 2C |
City Of The Provider |
WILLIAMSBURG |
Zip Code Of The Provider |
231885713 |
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 |
15 |
Number Of Services |
1505 |
Number Of Medicare Beneficiaries |
565 |
Total Submitted Charge Amount |
258106 |
Total Medicare Allowed Amount |
159907.46 |
Total Medicare Payment Amount |
123457.16 |
Total Medicare Standardized Payment Amount |
125737.87 |
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 |
15 |
Number Of Medical Services |
1505 |
Number Of Medicare Beneficiaries With Medical Services |
565 |
Total Medical Submitted Charge Amount |
258106 |
Total Medical Medicare Allowed Amount |
159907.46 |
Total Medical Medicare Payment Amount |
123457.16 |
Total Medical Medicare Standardized Payment Amount |
125737.87 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
141 |
Number Of Beneficiaries Age 75 to 84 |
170 |
Number Of Beneficiaries Age Greater 84 |
181 |
Number Of Female Beneficiaries |
326 |
Number Of Male Beneficiaries |
239 |
Number Of Non Hispanic White Beneficiaries |
438 |
Number Of Black or African American Beneficiaries |
113 |
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 |
462 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.144 |