National Provider Identifier [NPI]: |
1164478996 |
Last Name Of The Provider |
GREENBERG |
First Name Of The Provider |
RONALD |
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 |
350 S BROADWAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
HICKSVILLE |
Zip Code Of The Provider |
118015006 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
679 |
Number Of Medicare Beneficiaries |
128 |
Total Submitted Charge Amount |
66893.38 |
Total Medicare Allowed Amount |
39916.91 |
Total Medicare Payment Amount |
29391.94 |
Total Medicare Standardized Payment Amount |
25877.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
56 |
Number Of Medicare Beneficiaries With Drug Services |
48 |
Total Drug Submitted ChargeAmount |
3790.84 |
Total Drug Medicare AllowedAmount |
1823.51 |
Total Drug Medicare PaymentAmount |
1779.14 |
Total Drug Medicare Standardized Payment Amount |
1779.14 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
623 |
Number Of Medicare Beneficiaries With Medical Services |
128 |
Total Medical Submitted Charge Amount |
63102.54 |
Total Medical Medicare Allowed Amount |
38093.4 |
Total Medical Medicare Payment Amount |
27612.8 |
Total Medical Medicare Standardized Payment Amount |
24098.69 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
45 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
91 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
14 |
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
102 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8627 |