National Provider Identifier [NPI]: |
1033315031 |
Last Name Of The Provider |
MOTRAN |
First Name Of The Provider |
JOHNY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8903 SHADY GROVE CT |
Street Address 2 Of The Provider |
|
City Of The Provider |
GAITHERSBURG |
Zip Code Of The Provider |
208771308 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
2522 |
Number Of Medicare Beneficiaries |
466 |
Total Submitted Charge Amount |
210599.81 |
Total Medicare Allowed Amount |
128671.26 |
Total Medicare Payment Amount |
89581.25 |
Total Medicare Standardized Payment Amount |
78270.42 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
43 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
660 |
Total Drug Medicare AllowedAmount |
116.8 |
Total Drug Medicare PaymentAmount |
87.06 |
Total Drug Medicare Standardized Payment Amount |
87.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
2479 |
Number Of Medicare Beneficiaries With Medical Services |
466 |
Total Medical Submitted Charge Amount |
209939.81 |
Total Medical Medicare Allowed Amount |
128554.46 |
Total Medical Medicare Payment Amount |
89494.19 |
Total Medical Medicare Standardized Payment Amount |
78183.36 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
168 |
Number Of Beneficiaries Age 75 to 84 |
136 |
Number Of Beneficiaries Age Greater 84 |
110 |
Number Of Female Beneficiaries |
296 |
Number Of Male Beneficiaries |
170 |
Number Of Non Hispanic White Beneficiaries |
187 |
Number Of Black or African American Beneficiaries |
225 |
Number Of AsianPacific Islander Beneficiaries |
21 |
Number Of Hispanic Beneficiaries |
22 |
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 |
352 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4929 |