National Provider Identifier [NPI]: |
1255321915 |
Last Name Of The Provider |
GOEI |
First Name Of The Provider |
ANTHONY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1750 N HAMPTON RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DESOTO |
Zip Code Of The Provider |
751152306 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
170 |
Number Of Services |
6024 |
Number Of Medicare Beneficiaries |
670 |
Total Submitted Charge Amount |
2558400.24 |
Total Medicare Allowed Amount |
510047.38 |
Total Medicare Payment Amount |
398413.31 |
Total Medicare Standardized Payment Amount |
396630.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
3920 |
Number Of Medicare Beneficiaries With Drug Services |
273 |
Total Drug Submitted ChargeAmount |
26924.24 |
Total Drug Medicare AllowedAmount |
2819.31 |
Total Drug Medicare PaymentAmount |
2189.69 |
Total Drug Medicare Standardized Payment Amount |
2189.69 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
157 |
Number Of Medical Services |
2104 |
Number Of Medicare Beneficiaries With Medical Services |
670 |
Total Medical Submitted Charge Amount |
2531476 |
Total Medical Medicare Allowed Amount |
507228.07 |
Total Medical Medicare Payment Amount |
396223.62 |
Total Medical Medicare Standardized Payment Amount |
394441.21 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
201 |
Number Of Beneficiaries Age 65 to 74 |
266 |
Number Of Beneficiaries Age 75 to 84 |
152 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
386 |
Number Of Male Beneficiaries |
284 |
Number Of Non Hispanic White Beneficiaries |
320 |
Number Of Black or African American Beneficiaries |
266 |
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 |
384 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
286 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
56 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
3.3907 |