National Provider Identifier [NPI]: |
1215991948 |
Last Name Of The Provider |
RENARD |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
20905 PROFESSIONAL PLAZA |
Street Address 2 Of The Provider |
SUITE 330 |
City Of The Provider |
ASHBURN |
Zip Code Of The Provider |
20147 |
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 |
37 |
Number Of Services |
589 |
Number Of Medicare Beneficiaries |
136 |
Total Submitted Charge Amount |
72201 |
Total Medicare Allowed Amount |
32232.44 |
Total Medicare Payment Amount |
22251.06 |
Total Medicare Standardized Payment Amount |
22918.26 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
42 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
1665 |
Total Drug Medicare AllowedAmount |
978.34 |
Total Drug Medicare PaymentAmount |
853.89 |
Total Drug Medicare Standardized Payment Amount |
853.89 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
547 |
Number Of Medicare Beneficiaries With Medical Services |
136 |
Total Medical Submitted Charge Amount |
70536 |
Total Medical Medicare Allowed Amount |
31254.1 |
Total Medical Medicare Payment Amount |
21397.17 |
Total Medical Medicare Standardized Payment Amount |
22064.37 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
104 |
Number Of Male Beneficiaries |
32 |
Number Of Non Hispanic White Beneficiaries |
115 |
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
16 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7035 |