National Provider Identifier [NPI]: |
1366536815 |
Last Name Of The Provider |
JOLLES |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1250 E MARSHALL STREET |
Street Address 2 Of The Provider |
RADIOLOGY |
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
232980470 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nuclear Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
830 |
Number Of Medicare Beneficiaries |
749 |
Total Submitted Charge Amount |
258748 |
Total Medicare Allowed Amount |
68259.58 |
Total Medicare Payment Amount |
50878.84 |
Total Medicare Standardized Payment Amount |
52114.64 |
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 |
36 |
Number Of Medical Services |
830 |
Number Of Medicare Beneficiaries With Medical Services |
749 |
Total Medical Submitted Charge Amount |
258748 |
Total Medical Medicare Allowed Amount |
68259.58 |
Total Medical Medicare Payment Amount |
50878.84 |
Total Medical Medicare Standardized Payment Amount |
52114.64 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
221 |
Number Of Beneficiaries Age 65 to 74 |
313 |
Number Of Beneficiaries Age 75 to 84 |
183 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
390 |
Number Of Male Beneficiaries |
359 |
Number Of Non Hispanic White Beneficiaries |
416 |
Number Of Black or African American Beneficiaries |
305 |
Number Of AsianPacific Islander Beneficiaries |
11 |
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 |
497 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
252 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
29 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.2759 |