National Provider Identifier [NPI]: |
1043263148 |
Last Name Of The Provider |
MELTVEDT |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1077 N SHENANDOAH AVE |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
FRONT ROYAL |
Zip Code Of The Provider |
226303546 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
84 |
Number Of Services |
559 |
Number Of Medicare Beneficiaries |
304 |
Total Submitted Charge Amount |
178903.6 |
Total Medicare Allowed Amount |
80411.28 |
Total Medicare Payment Amount |
59608.74 |
Total Medicare Standardized Payment Amount |
62545.98 |
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 |
84 |
Number Of Medical Services |
559 |
Number Of Medicare Beneficiaries With Medical Services |
304 |
Total Medical Submitted Charge Amount |
178903.6 |
Total Medical Medicare Allowed Amount |
80411.28 |
Total Medical Medicare Payment Amount |
59608.74 |
Total Medical Medicare Standardized Payment Amount |
62545.98 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
73 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
163 |
Number Of Male Beneficiaries |
141 |
Number Of Non Hispanic White Beneficiaries |
281 |
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 |
244 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0633 |