National Provider Identifier [NPI]: |
1124051677 |
Last Name Of The Provider |
SOOFER |
First Name Of The Provider |
STEPHANIE |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1625 N GEORGE MASON DR |
Street Address 2 Of The Provider |
PATHOLOGY DEPT |
City Of The Provider |
ARLINGTON |
Zip Code Of The Provider |
222053683 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
4536 |
Number Of Medicare Beneficiaries |
1125 |
Total Submitted Charge Amount |
919193 |
Total Medicare Allowed Amount |
162031.37 |
Total Medicare Payment Amount |
125864.56 |
Total Medicare Standardized Payment Amount |
84612.52 |
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 |
34 |
Number Of Medical Services |
4536 |
Number Of Medicare Beneficiaries With Medical Services |
1125 |
Total Medical Submitted Charge Amount |
919193 |
Total Medical Medicare Allowed Amount |
162031.37 |
Total Medical Medicare Payment Amount |
125864.56 |
Total Medical Medicare Standardized Payment Amount |
84612.52 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
583 |
Number Of Beneficiaries Age 75 to 84 |
356 |
Number Of Beneficiaries Age Greater 84 |
98 |
Number Of Female Beneficiaries |
642 |
Number Of Male Beneficiaries |
483 |
Number Of Non Hispanic White Beneficiaries |
828 |
Number Of Black or African American Beneficiaries |
112 |
Number Of AsianPacific Islander Beneficiaries |
57 |
Number Of Hispanic Beneficiaries |
95 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
33 |
Number Of Beneficiaries With Medicare Only Entitlement |
1024 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
101 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1044 |