National Provider Identifier [NPI]: |
1871558130 |
Last Name Of The Provider |
GOINS |
First Name Of The Provider |
ERNEST |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5486 INDIAN RIVER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
VIRGINIA BEACH |
Zip Code Of The Provider |
234645365 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
915 |
Number Of Medicare Beneficiaries |
342 |
Total Submitted Charge Amount |
85871 |
Total Medicare Allowed Amount |
37953.72 |
Total Medicare Payment Amount |
26630.33 |
Total Medicare Standardized Payment Amount |
28108.32 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
39 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
318 |
Total Drug Medicare AllowedAmount |
94.11 |
Total Drug Medicare PaymentAmount |
76.42 |
Total Drug Medicare Standardized Payment Amount |
76.42 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
59 |
Number Of Medical Services |
876 |
Number Of Medicare Beneficiaries With Medical Services |
342 |
Total Medical Submitted Charge Amount |
85553 |
Total Medical Medicare Allowed Amount |
37859.61 |
Total Medical Medicare Payment Amount |
26553.91 |
Total Medical Medicare Standardized Payment Amount |
28031.9 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
170 |
Number Of Beneficiaries Age 75 to 84 |
89 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
203 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
235 |
Number Of Black or African American Beneficiaries |
75 |
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 |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
320 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0175 |