National Provider Identifier [NPI]: |
1134199433 |
Last Name Of The Provider |
GOLDSTEIN |
First Name Of The Provider |
LAWRENCE |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
960 WINDHAM CT |
Street Address 2 Of The Provider |
SUITE 1 |
City Of The Provider |
BOARDMAN |
Zip Code Of The Provider |
445125087 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
2157 |
Number Of Medicare Beneficiaries |
556 |
Total Submitted Charge Amount |
211571 |
Total Medicare Allowed Amount |
177321.59 |
Total Medicare Payment Amount |
134235.29 |
Total Medicare Standardized Payment Amount |
138656.88 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
44 |
Number Of Medicare Beneficiaries With Drug Services |
35 |
Total Drug Submitted ChargeAmount |
1048 |
Total Drug Medicare AllowedAmount |
509.55 |
Total Drug Medicare PaymentAmount |
488.19 |
Total Drug Medicare Standardized Payment Amount |
488.19 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
51 |
Number Of Medical Services |
2113 |
Number Of Medicare Beneficiaries With Medical Services |
556 |
Total Medical Submitted Charge Amount |
210523 |
Total Medical Medicare Allowed Amount |
176812.04 |
Total Medical Medicare Payment Amount |
133747.1 |
Total Medical Medicare Standardized Payment Amount |
138168.69 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
113 |
Number Of Beneficiaries Age 65 to 74 |
199 |
Number Of Beneficiaries Age 75 to 84 |
161 |
Number Of Beneficiaries Age Greater 84 |
83 |
Number Of Female Beneficiaries |
299 |
Number Of Male Beneficiaries |
257 |
Number Of Non Hispanic White Beneficiaries |
451 |
Number Of Black or African American Beneficiaries |
84 |
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 |
376 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
180 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
27 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
57 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.3914 |