National Provider Identifier [NPI]: |
1215904859 |
Last Name Of The Provider |
GRODZIN |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
550 PEACHTREE ST NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303082212 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
3124 |
Number Of Medicare Beneficiaries |
604 |
Total Submitted Charge Amount |
650728 |
Total Medicare Allowed Amount |
248232.87 |
Total Medicare Payment Amount |
188005.11 |
Total Medicare Standardized Payment Amount |
192886.38 |
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 |
33 |
Number Of Medical Services |
3124 |
Number Of Medicare Beneficiaries With Medical Services |
604 |
Total Medical Submitted Charge Amount |
650728 |
Total Medical Medicare Allowed Amount |
248232.87 |
Total Medical Medicare Payment Amount |
188005.11 |
Total Medical Medicare Standardized Payment Amount |
192886.38 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
116 |
Number Of Beneficiaries Age 65 to 74 |
211 |
Number Of Beneficiaries Age 75 to 84 |
188 |
Number Of Beneficiaries Age Greater 84 |
89 |
Number Of Female Beneficiaries |
337 |
Number Of Male Beneficiaries |
267 |
Number Of Non Hispanic White Beneficiaries |
457 |
Number Of Black or African American Beneficiaries |
119 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
429 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
175 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
62 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.8778 |