National Provider Identifier [NPI]: |
1235164286 |
Last Name Of The Provider |
GUBIN |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6029 WALNUT GROVE RD. |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
38120 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
156 |
Number Of Services |
38814 |
Number Of Medicare Beneficiaries |
1069 |
Total Submitted Charge Amount |
5234308 |
Total Medicare Allowed Amount |
960595.46 |
Total Medicare Payment Amount |
721449.21 |
Total Medicare Standardized Payment Amount |
791483.84 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
26235 |
Number Of Medicare Beneficiaries With Drug Services |
382 |
Total Drug Submitted ChargeAmount |
140079 |
Total Drug Medicare AllowedAmount |
39485.62 |
Total Drug Medicare PaymentAmount |
30687.77 |
Total Drug Medicare Standardized Payment Amount |
30687.77 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
146 |
Number Of Medical Services |
12579 |
Number Of Medicare Beneficiaries With Medical Services |
1069 |
Total Medical Submitted Charge Amount |
5094229 |
Total Medical Medicare Allowed Amount |
921109.84 |
Total Medical Medicare Payment Amount |
690761.44 |
Total Medical Medicare Standardized Payment Amount |
760796.07 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
149 |
Number Of Beneficiaries Age 65 to 74 |
462 |
Number Of Beneficiaries Age 75 to 84 |
343 |
Number Of Beneficiaries Age Greater 84 |
115 |
Number Of Female Beneficiaries |
341 |
Number Of Male Beneficiaries |
728 |
Number Of Non Hispanic White Beneficiaries |
845 |
Number Of Black or African American Beneficiaries |
201 |
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 |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
907 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
162 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2821 |