National Provider Identifier [NPI]: |
1003924838 |
Last Name Of The Provider |
GODINE |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
50 STANIFORD STREET |
Street Address 2 Of The Provider |
3RD FLOOR S50 3 DIABETES UNIT |
City Of The Provider |
BOSTON |
Zip Code Of The Provider |
02114 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
6039 |
Number Of Medicare Beneficiaries |
717 |
Total Submitted Charge Amount |
1258677 |
Total Medicare Allowed Amount |
398356.03 |
Total Medicare Payment Amount |
306735.85 |
Total Medicare Standardized Payment Amount |
296198.06 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
429 |
Number Of Medicare Beneficiaries With Drug Services |
145 |
Total Drug Submitted ChargeAmount |
95450 |
Total Drug Medicare AllowedAmount |
48951.32 |
Total Drug Medicare PaymentAmount |
41826.65 |
Total Drug Medicare Standardized Payment Amount |
41826.65 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
5610 |
Number Of Medicare Beneficiaries With Medical Services |
717 |
Total Medical Submitted Charge Amount |
1163227 |
Total Medical Medicare Allowed Amount |
349404.71 |
Total Medical Medicare Payment Amount |
264909.2 |
Total Medical Medicare Standardized Payment Amount |
254371.41 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
306 |
Number Of Beneficiaries Age 75 to 84 |
225 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
259 |
Number Of Male Beneficiaries |
458 |
Number Of Non Hispanic White Beneficiaries |
618 |
Number Of Black or African American Beneficiaries |
33 |
Number Of AsianPacific Islander Beneficiaries |
17 |
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
20 |
Number Of Beneficiaries With Medicare Only Entitlement |
554 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
163 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.5266 |