National Provider Identifier [NPI]: |
1063529832 |
Last Name Of The Provider |
GOEL |
First Name Of The Provider |
ARCHANA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
901 CENTER STREET |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
ELGIN |
Zip Code Of The Provider |
60120 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
2074 |
Number Of Medicare Beneficiaries |
329 |
Total Submitted Charge Amount |
258345 |
Total Medicare Allowed Amount |
161509.44 |
Total Medicare Payment Amount |
118387.22 |
Total Medicare Standardized Payment Amount |
109133.02 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
154 |
Number Of Medicare Beneficiaries With Drug Services |
144 |
Total Drug Submitted ChargeAmount |
8280 |
Total Drug Medicare AllowedAmount |
3568.73 |
Total Drug Medicare PaymentAmount |
3496.59 |
Total Drug Medicare Standardized Payment Amount |
3496.59 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
1920 |
Number Of Medicare Beneficiaries With Medical Services |
329 |
Total Medical Submitted Charge Amount |
250065 |
Total Medical Medicare Allowed Amount |
157940.71 |
Total Medical Medicare Payment Amount |
114890.63 |
Total Medical Medicare Standardized Payment Amount |
105636.43 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
144 |
Number Of Beneficiaries Age 75 to 84 |
97 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
231 |
Number Of Male Beneficiaries |
98 |
Number Of Non Hispanic White Beneficiaries |
260 |
Number Of Black or African American Beneficiaries |
15 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
33 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
286 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.134 |