National Provider Identifier [NPI]: |
1629023833 |
Last Name Of The Provider |
MERSON |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2621 GROVE AVENUE |
Street Address 2 Of The Provider |
|
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
232204300 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
784 |
Number Of Medicare Beneficiaries |
688 |
Total Submitted Charge Amount |
564301.25 |
Total Medicare Allowed Amount |
80603.54 |
Total Medicare Payment Amount |
60873.68 |
Total Medicare Standardized Payment Amount |
62295.21 |
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 |
79 |
Number Of Medical Services |
784 |
Number Of Medicare Beneficiaries With Medical Services |
688 |
Total Medical Submitted Charge Amount |
564301.25 |
Total Medical Medicare Allowed Amount |
80603.54 |
Total Medical Medicare Payment Amount |
60873.68 |
Total Medical Medicare Standardized Payment Amount |
62295.21 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
94 |
Number Of Beneficiaries Age 65 to 74 |
380 |
Number Of Beneficiaries Age 75 to 84 |
167 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
400 |
Number Of Male Beneficiaries |
288 |
Number Of Non Hispanic White Beneficiaries |
468 |
Number Of Black or African American Beneficiaries |
202 |
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 |
567 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
121 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4008 |