National Provider Identifier [NPI]: |
1093932444 |
Last Name Of The Provider |
VALERIO |
First Name Of The Provider |
HERNANI |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12715 WARWICK BLVD |
Street Address 2 Of The Provider |
SUITE O |
City Of The Provider |
NEWPORT NEWS |
Zip Code Of The Provider |
236061800 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
68 |
Number Of Services |
4320 |
Number Of Medicare Beneficiaries |
396 |
Total Submitted Charge Amount |
281259 |
Total Medicare Allowed Amount |
173760.34 |
Total Medicare Payment Amount |
129521.82 |
Total Medicare Standardized Payment Amount |
132507.76 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
128 |
Number Of Medicare Beneficiaries With Drug Services |
109 |
Total Drug Submitted ChargeAmount |
5631 |
Total Drug Medicare AllowedAmount |
4067.31 |
Total Drug Medicare PaymentAmount |
3984.1 |
Total Drug Medicare Standardized Payment Amount |
3984.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
63 |
Number Of Medical Services |
4192 |
Number Of Medicare Beneficiaries With Medical Services |
396 |
Total Medical Submitted Charge Amount |
275628 |
Total Medical Medicare Allowed Amount |
169693.03 |
Total Medical Medicare Payment Amount |
125537.72 |
Total Medical Medicare Standardized Payment Amount |
128523.66 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
114 |
Number Of Beneficiaries Age 65 to 74 |
131 |
Number Of Beneficiaries Age 75 to 84 |
83 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
226 |
Number Of Male Beneficiaries |
170 |
Number Of Non Hispanic White Beneficiaries |
199 |
Number Of Black or African American Beneficiaries |
154 |
Number Of AsianPacific Islander Beneficiaries |
18 |
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 |
267 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
129 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2961 |