National Provider Identifier [NPI]: |
1043213051 |
Last Name Of The Provider |
GOROVOY |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12381 S CLEVELAND AVE |
Street Address 2 Of The Provider |
STE 300 |
City Of The Provider |
FORT MYERS |
Zip Code Of The Provider |
339073852 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
105 |
Number Of Services |
11909 |
Number Of Medicare Beneficiaries |
3378 |
Total Submitted Charge Amount |
6375260.5 |
Total Medicare Allowed Amount |
2191968.12 |
Total Medicare Payment Amount |
1623134.09 |
Total Medicare Standardized Payment Amount |
1549006.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
563 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
286997.5 |
Total Drug Medicare AllowedAmount |
188442.91 |
Total Drug Medicare PaymentAmount |
147738.88 |
Total Drug Medicare Standardized Payment Amount |
147738.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
102 |
Number Of Medical Services |
11346 |
Number Of Medicare Beneficiaries With Medical Services |
3378 |
Total Medical Submitted Charge Amount |
6088263 |
Total Medical Medicare Allowed Amount |
2003525.21 |
Total Medical Medicare Payment Amount |
1475395.21 |
Total Medical Medicare Standardized Payment Amount |
1401268.05 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
100 |
Number Of Beneficiaries Age 65 to 74 |
1321 |
Number Of Beneficiaries Age 75 to 84 |
1333 |
Number Of Beneficiaries Age Greater 84 |
624 |
Number Of Female Beneficiaries |
1920 |
Number Of Male Beneficiaries |
1458 |
Number Of Non Hispanic White Beneficiaries |
3164 |
Number Of Black or African American Beneficiaries |
60 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
84 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
49 |
Number Of Beneficiaries With Medicare Only Entitlement |
3243 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
135 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0528 |