National Provider Identifier [NPI]: |
1932140092 |
Last Name Of The Provider |
GOBIN |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2900 12TH AVE N |
Street Address 2 Of The Provider |
SUITE 160W |
City Of The Provider |
BILLINGS |
Zip Code Of The Provider |
591017506 |
State Code Of The Provider |
MT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
1401 |
Number Of Medicare Beneficiaries |
539 |
Total Submitted Charge Amount |
369482 |
Total Medicare Allowed Amount |
154119.9 |
Total Medicare Payment Amount |
119276.99 |
Total Medicare Standardized Payment Amount |
123578.09 |
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 |
15 |
Number Of Medical Services |
1401 |
Number Of Medicare Beneficiaries With Medical Services |
539 |
Total Medical Submitted Charge Amount |
369482 |
Total Medical Medicare Allowed Amount |
154119.9 |
Total Medical Medicare Payment Amount |
119276.99 |
Total Medical Medicare Standardized Payment Amount |
123578.09 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
105 |
Number Of Beneficiaries Age 65 to 74 |
169 |
Number Of Beneficiaries Age 75 to 84 |
159 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
300 |
Number Of Male Beneficiaries |
239 |
Number Of Non Hispanic White Beneficiaries |
499 |
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 |
341 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
198 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
46 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.2866 |