National Provider Identifier [NPI]: |
1942496872 |
Last Name Of The Provider |
DAVIS |
First Name Of The Provider |
MARSHA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
830 KEMPSVILLE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORFOLK |
Zip Code Of The Provider |
235023920 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1454 |
Number Of Medicare Beneficiaries |
473 |
Total Submitted Charge Amount |
206150 |
Total Medicare Allowed Amount |
125083.96 |
Total Medicare Payment Amount |
96254.1 |
Total Medicare Standardized Payment Amount |
98936.12 |
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 |
17 |
Number Of Medical Services |
1454 |
Number Of Medicare Beneficiaries With Medical Services |
473 |
Total Medical Submitted Charge Amount |
206150 |
Total Medical Medicare Allowed Amount |
125083.96 |
Total Medical Medicare Payment Amount |
96254.1 |
Total Medical Medicare Standardized Payment Amount |
98936.12 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
157 |
Number Of Beneficiaries Age 75 to 84 |
150 |
Number Of Beneficiaries Age Greater 84 |
108 |
Number Of Female Beneficiaries |
314 |
Number Of Male Beneficiaries |
159 |
Number Of Non Hispanic White Beneficiaries |
344 |
Number Of Black or African American Beneficiaries |
108 |
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 |
391 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
82 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.9228 |