National Provider Identifier [NPI]: |
1609848845 |
Last Name Of The Provider |
SANDLIN |
First Name Of The Provider |
RENEE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
411 W RANDOLPH RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOPEWELL |
Zip Code Of The Provider |
238602938 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1086 |
Number Of Medicare Beneficiaries |
832 |
Total Submitted Charge Amount |
1033063 |
Total Medicare Allowed Amount |
151455.38 |
Total Medicare Payment Amount |
115048.81 |
Total Medicare Standardized Payment Amount |
117510.66 |
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 |
29 |
Number Of Medical Services |
1086 |
Number Of Medicare Beneficiaries With Medical Services |
832 |
Total Medical Submitted Charge Amount |
1033063 |
Total Medical Medicare Allowed Amount |
151455.38 |
Total Medical Medicare Payment Amount |
115048.81 |
Total Medical Medicare Standardized Payment Amount |
117510.66 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
255 |
Number Of Beneficiaries Age 65 to 74 |
247 |
Number Of Beneficiaries Age 75 to 84 |
206 |
Number Of Beneficiaries Age Greater 84 |
124 |
Number Of Female Beneficiaries |
511 |
Number Of Male Beneficiaries |
321 |
Number Of Non Hispanic White Beneficiaries |
479 |
Number Of Black or African American Beneficiaries |
328 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
543 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
289 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.8341 |