National Provider Identifier [NPI]: |
1144490624 |
Last Name Of The Provider |
SALOMONSKY |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3636 HIGH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORTSMOUTH |
Zip Code Of The Provider |
237073236 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
1201 |
Number Of Medicare Beneficiaries |
650 |
Total Submitted Charge Amount |
662283 |
Total Medicare Allowed Amount |
121936.54 |
Total Medicare Payment Amount |
92940.81 |
Total Medicare Standardized Payment Amount |
92705.25 |
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 |
26 |
Number Of Medical Services |
1201 |
Number Of Medicare Beneficiaries With Medical Services |
650 |
Total Medical Submitted Charge Amount |
662283 |
Total Medical Medicare Allowed Amount |
121936.54 |
Total Medical Medicare Payment Amount |
92940.81 |
Total Medical Medicare Standardized Payment Amount |
92705.25 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
177 |
Number Of Beneficiaries Age 65 to 74 |
158 |
Number Of Beneficiaries Age 75 to 84 |
171 |
Number Of Beneficiaries Age Greater 84 |
144 |
Number Of Female Beneficiaries |
375 |
Number Of Male Beneficiaries |
275 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
340 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
438 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
212 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.4338 |