National Provider Identifier [NPI]: |
1194996132 |
Last Name Of The Provider |
BALA |
First Name Of The Provider |
FARIN |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1250 E MARSHALL ST |
Street Address 2 Of The Provider |
INTERNAL MEDICINE |
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
232985051 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
270 |
Number Of Medicare Beneficiaries |
246 |
Total Submitted Charge Amount |
19623 |
Total Medicare Allowed Amount |
8872.35 |
Total Medicare Payment Amount |
6269.8 |
Total Medicare Standardized Payment Amount |
7681.05 |
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 |
12 |
Number Of Medical Services |
270 |
Number Of Medicare Beneficiaries With Medical Services |
246 |
Total Medical Submitted Charge Amount |
19623 |
Total Medical Medicare Allowed Amount |
8872.35 |
Total Medical Medicare Payment Amount |
6269.8 |
Total Medical Medicare Standardized Payment Amount |
7681.05 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
113 |
Number Of Beneficiaries Age 75 to 84 |
81 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
234 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
211 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3618 |