National Provider Identifier [NPI]: |
1245411537 |
Last Name Of The Provider |
REZBA |
First Name Of The Provider |
AMANDA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
NP-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1115 BOULDERS PKWY |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
NORTH CHESTERFIELD |
Zip Code Of The Provider |
232254067 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
381 |
Number Of Medicare Beneficiaries |
174 |
Total Submitted Charge Amount |
47019 |
Total Medicare Allowed Amount |
18834.13 |
Total Medicare Payment Amount |
13280.22 |
Total Medicare Standardized Payment Amount |
16343.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
54 |
Number Of Medicare Beneficiaries With Drug Services |
34 |
Total Drug Submitted ChargeAmount |
378 |
Total Drug Medicare AllowedAmount |
307.96 |
Total Drug Medicare PaymentAmount |
230.54 |
Total Drug Medicare Standardized Payment Amount |
230.54 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
327 |
Number Of Medicare Beneficiaries With Medical Services |
174 |
Total Medical Submitted Charge Amount |
46641 |
Total Medical Medicare Allowed Amount |
18526.17 |
Total Medical Medicare Payment Amount |
13049.68 |
Total Medical Medicare Standardized Payment Amount |
16112.74 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
83 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
115 |
Number Of Male Beneficiaries |
59 |
Number Of Non Hispanic White Beneficiaries |
135 |
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 |
155 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3936 |