National Provider Identifier [NPI]: |
1144420746 |
Last Name Of The Provider |
PAYNE |
First Name Of The Provider |
JASON |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1906 BELLEVIEW AVE SE |
Street Address 2 Of The Provider |
CARILION ROANOKE MEMORIAL HOSPITAL |
City Of The Provider |
ROANOKE |
Zip Code Of The Provider |
240141838 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
592 |
Number Of Medicare Beneficiaries |
260 |
Total Submitted Charge Amount |
75134.07 |
Total Medicare Allowed Amount |
74068.99 |
Total Medicare Payment Amount |
55676.28 |
Total Medicare Standardized Payment Amount |
57052.45 |
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 |
16 |
Number Of Medical Services |
592 |
Number Of Medicare Beneficiaries With Medical Services |
260 |
Total Medical Submitted Charge Amount |
75134.07 |
Total Medical Medicare Allowed Amount |
74068.99 |
Total Medical Medicare Payment Amount |
55676.28 |
Total Medical Medicare Standardized Payment Amount |
57052.45 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
83 |
Number Of Beneficiaries Age Greater 84 |
56 |
Number Of Female Beneficiaries |
141 |
Number Of Male Beneficiaries |
119 |
Number Of Non Hispanic White Beneficiaries |
175 |
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 |
129 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
71 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
2.4479 |