National Provider Identifier [NPI]: |
1477546695 |
Last Name Of The Provider |
HEINTZ |
First Name Of The Provider |
JESSICA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2900 TELESTAR CT |
Street Address 2 Of The Provider |
|
City Of The Provider |
FALLS CHURCH |
Zip Code Of The Provider |
220421206 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hospice and Palliative Care |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
192 |
Number Of Medicare Beneficiaries |
111 |
Total Submitted Charge Amount |
61264 |
Total Medicare Allowed Amount |
28324.38 |
Total Medicare Payment Amount |
22054.71 |
Total Medicare Standardized Payment Amount |
20175.4 |
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 |
11 |
Number Of Medical Services |
192 |
Number Of Medicare Beneficiaries With Medical Services |
111 |
Total Medical Submitted Charge Amount |
61264 |
Total Medical Medicare Allowed Amount |
28324.38 |
Total Medical Medicare Payment Amount |
22054.71 |
Total Medical Medicare Standardized Payment Amount |
20175.4 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
37 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
60 |
Number Of Male Beneficiaries |
51 |
Number Of Non Hispanic White Beneficiaries |
80 |
Number Of Black or African American Beneficiaries |
13 |
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 |
79 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
46 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
32 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
66 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.3377 |