National Provider Identifier [NPI]: |
1164475257 |
Last Name Of The Provider |
GROSS |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
333 ARTHUR GODFREY RD |
Street Address 2 Of The Provider |
SUITE 302 |
City Of The Provider |
MIAMI BEACH |
Zip Code Of The Provider |
331403641 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
2626 |
Number Of Medicare Beneficiaries |
506 |
Total Submitted Charge Amount |
749709.86 |
Total Medicare Allowed Amount |
558911.69 |
Total Medicare Payment Amount |
433123.9 |
Total Medicare Standardized Payment Amount |
378664.33 |
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 |
64 |
Number Of Medical Services |
2626 |
Number Of Medicare Beneficiaries With Medical Services |
506 |
Total Medical Submitted Charge Amount |
749709.86 |
Total Medical Medicare Allowed Amount |
558911.69 |
Total Medical Medicare Payment Amount |
433123.9 |
Total Medical Medicare Standardized Payment Amount |
378664.33 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
171 |
Number Of Beneficiaries Age 75 to 84 |
174 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
219 |
Number Of Male Beneficiaries |
287 |
Number Of Non Hispanic White Beneficiaries |
415 |
Number Of Black or African American Beneficiaries |
|
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 |
444 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.3059 |