National Provider Identifier [NPI]: |
1508870205 |
Last Name Of The Provider |
GOFF |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
70 MEDICAL CENTER CIR |
Street Address 2 Of The Provider |
SUITE 213 |
City Of The Provider |
FISHERSVILLE |
Zip Code Of The Provider |
229392273 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
133 |
Number Of Services |
2028 |
Number Of Medicare Beneficiaries |
850 |
Total Submitted Charge Amount |
781487 |
Total Medicare Allowed Amount |
334690.93 |
Total Medicare Payment Amount |
255341.13 |
Total Medicare Standardized Payment Amount |
266991.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
133 |
Number Of Medical Services |
2028 |
Number Of Medicare Beneficiaries With Medical Services |
850 |
Total Medical Submitted Charge Amount |
781487 |
Total Medical Medicare Allowed Amount |
334690.93 |
Total Medical Medicare Payment Amount |
255341.13 |
Total Medical Medicare Standardized Payment Amount |
266991.36 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
115 |
Number Of Beneficiaries Age 65 to 74 |
329 |
Number Of Beneficiaries Age 75 to 84 |
283 |
Number Of Beneficiaries Age Greater 84 |
123 |
Number Of Female Beneficiaries |
418 |
Number Of Male Beneficiaries |
432 |
Number Of Non Hispanic White Beneficiaries |
786 |
Number Of Black or African American Beneficiaries |
53 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
673 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
177 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.1006 |