National Provider Identifier [NPI]: |
1467678979 |
Last Name Of The Provider |
DARNELL |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3100 MACCORKLE AVE SE |
Street Address 2 Of The Provider |
SUITE 604 |
City Of The Provider |
CHARLESTON |
Zip Code Of The Provider |
253041223 |
State Code Of The Provider |
WV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
823 |
Number Of Medicare Beneficiaries |
304 |
Total Submitted Charge Amount |
145985 |
Total Medicare Allowed Amount |
74449.55 |
Total Medicare Payment Amount |
57908.54 |
Total Medicare Standardized Payment Amount |
59686.12 |
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 |
14 |
Number Of Medical Services |
823 |
Number Of Medicare Beneficiaries With Medical Services |
304 |
Total Medical Submitted Charge Amount |
145985 |
Total Medical Medicare Allowed Amount |
74449.55 |
Total Medical Medicare Payment Amount |
57908.54 |
Total Medical Medicare Standardized Payment Amount |
59686.12 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
73 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
142 |
Number Of Male Beneficiaries |
162 |
Number Of Non Hispanic White Beneficiaries |
249 |
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 |
191 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
113 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
68 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.9558 |