National Provider Identifier [NPI]: |
1194708131 |
Last Name Of The Provider |
GOLDBERGER |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3922 WOODLEY RD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
TOLEDO |
Zip Code Of The Provider |
436061130 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
39969 |
Number Of Medicare Beneficiaries |
458 |
Total Submitted Charge Amount |
811931 |
Total Medicare Allowed Amount |
639807.81 |
Total Medicare Payment Amount |
493312.22 |
Total Medicare Standardized Payment Amount |
499408.17 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
34804 |
Number Of Medicare Beneficiaries With Drug Services |
150 |
Total Drug Submitted ChargeAmount |
542504 |
Total Drug Medicare AllowedAmount |
463113.87 |
Total Drug Medicare PaymentAmount |
362983.43 |
Total Drug Medicare Standardized Payment Amount |
362983.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
63 |
Number Of Medical Services |
5165 |
Number Of Medicare Beneficiaries With Medical Services |
458 |
Total Medical Submitted Charge Amount |
269427 |
Total Medical Medicare Allowed Amount |
176693.94 |
Total Medical Medicare Payment Amount |
130328.79 |
Total Medical Medicare Standardized Payment Amount |
136424.74 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
206 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
330 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
374 |
Number Of Black or African American Beneficiaries |
60 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
367 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
91 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4445 |