National Provider Identifier [NPI]: |
1518171297 |
Last Name Of The Provider |
TRACCI |
First Name Of The Provider |
MARGARET |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
LEE ST FL 2 |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHARLOTTESVILLE |
Zip Code Of The Provider |
229080001 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
123 |
Number Of Services |
1309 |
Number Of Medicare Beneficiaries |
720 |
Total Submitted Charge Amount |
736874.98 |
Total Medicare Allowed Amount |
159230.02 |
Total Medicare Payment Amount |
122566.62 |
Total Medicare Standardized Payment Amount |
126010.27 |
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 |
123 |
Number Of Medical Services |
1309 |
Number Of Medicare Beneficiaries With Medical Services |
720 |
Total Medical Submitted Charge Amount |
736874.98 |
Total Medical Medicare Allowed Amount |
159230.02 |
Total Medical Medicare Payment Amount |
122566.62 |
Total Medical Medicare Standardized Payment Amount |
126010.27 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
123 |
Number Of Beneficiaries Age 65 to 74 |
306 |
Number Of Beneficiaries Age 75 to 84 |
216 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
334 |
Number Of Male Beneficiaries |
386 |
Number Of Non Hispanic White Beneficiaries |
595 |
Number Of Black or African American Beneficiaries |
109 |
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 |
568 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
152 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.872 |