National Provider Identifier [NPI]: |
1386630663 |
Last Name Of The Provider |
GOEDKEN |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
811 5TH AVE SE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CEDAR RAPIDS |
Zip Code Of The Provider |
524032421 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
1553 |
Number Of Medicare Beneficiaries |
294 |
Total Submitted Charge Amount |
273543 |
Total Medicare Allowed Amount |
137590.34 |
Total Medicare Payment Amount |
98790.32 |
Total Medicare Standardized Payment Amount |
106930.4 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
100 |
Number Of Medicare Beneficiaries With Drug Services |
70 |
Total Drug Submitted ChargeAmount |
6390 |
Total Drug Medicare AllowedAmount |
4521.43 |
Total Drug Medicare PaymentAmount |
3899.76 |
Total Drug Medicare Standardized Payment Amount |
3899.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
1453 |
Number Of Medicare Beneficiaries With Medical Services |
294 |
Total Medical Submitted Charge Amount |
267153 |
Total Medical Medicare Allowed Amount |
133068.91 |
Total Medical Medicare Payment Amount |
94890.56 |
Total Medical Medicare Standardized Payment Amount |
103030.64 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
166 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
162 |
Number Of Male Beneficiaries |
132 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8357 |