National Provider Identifier [NPI]: |
1679797369 |
Last Name Of The Provider |
GONZALEZ-COTA |
First Name Of The Provider |
ALAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12240 INDIAN CREEK CT |
Street Address 2 Of The Provider |
SUITE 130A |
City Of The Provider |
BELTSVILLE |
Zip Code Of The Provider |
207051242 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
2592 |
Number Of Medicare Beneficiaries |
329 |
Total Submitted Charge Amount |
490221.46 |
Total Medicare Allowed Amount |
188783.55 |
Total Medicare Payment Amount |
142865.62 |
Total Medicare Standardized Payment Amount |
135262.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
695 |
Number Of Medicare Beneficiaries With Drug Services |
121 |
Total Drug Submitted ChargeAmount |
4525.77 |
Total Drug Medicare AllowedAmount |
1236.04 |
Total Drug Medicare PaymentAmount |
968.87 |
Total Drug Medicare Standardized Payment Amount |
968.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
1897 |
Number Of Medicare Beneficiaries With Medical Services |
329 |
Total Medical Submitted Charge Amount |
485695.69 |
Total Medical Medicare Allowed Amount |
187547.51 |
Total Medical Medicare Payment Amount |
141896.75 |
Total Medical Medicare Standardized Payment Amount |
134293.52 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
165 |
Number Of Beneficiaries Age 65 to 74 |
104 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
212 |
Number Of Male Beneficiaries |
117 |
Number Of Non Hispanic White Beneficiaries |
276 |
Number Of Black or African American Beneficiaries |
41 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
196 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
133 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
3 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4681 |