National Provider Identifier [NPI]: |
1538133509 |
Last Name Of The Provider |
FLENNER |
First Name Of The Provider |
RONALD |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
825 FAIRFAX AVE |
Street Address 2 Of The Provider |
SUITE 545 |
City Of The Provider |
NORFOLK |
Zip Code Of The Provider |
235071914 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
347 |
Number Of Medicare Beneficiaries |
112 |
Total Submitted Charge Amount |
43415 |
Total Medicare Allowed Amount |
24317.31 |
Total Medicare Payment Amount |
18630.04 |
Total Medicare Standardized Payment Amount |
18947.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
43 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
1710 |
Total Drug Medicare AllowedAmount |
864.41 |
Total Drug Medicare PaymentAmount |
826.25 |
Total Drug Medicare Standardized Payment Amount |
826.25 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
304 |
Number Of Medicare Beneficiaries With Medical Services |
112 |
Total Medical Submitted Charge Amount |
41705 |
Total Medical Medicare Allowed Amount |
23452.9 |
Total Medical Medicare Payment Amount |
17803.79 |
Total Medical Medicare Standardized Payment Amount |
18120.96 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
37 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
40 |
Number Of Male Beneficiaries |
72 |
Number Of Non Hispanic White Beneficiaries |
54 |
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 |
72 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
69 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.9019 |