National Provider Identifier [NPI]: |
1134250798 |
Last Name Of The Provider |
SHERMAN |
First Name Of The Provider |
MARTIN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
193 BROADWAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
AMITYVILLE |
Zip Code Of The Provider |
117012761 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
2798 |
Number Of Medicare Beneficiaries |
192 |
Total Submitted Charge Amount |
187105 |
Total Medicare Allowed Amount |
127075.81 |
Total Medicare Payment Amount |
93904.47 |
Total Medicare Standardized Payment Amount |
79207.79 |
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 |
13 |
Number Of Medical Services |
2798 |
Number Of Medicare Beneficiaries With Medical Services |
192 |
Total Medical Submitted Charge Amount |
187105 |
Total Medical Medicare Allowed Amount |
127075.81 |
Total Medical Medicare Payment Amount |
93904.47 |
Total Medical Medicare Standardized Payment Amount |
79207.79 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
94 |
Number Of Male Beneficiaries |
98 |
Number Of Non Hispanic White Beneficiaries |
168 |
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 |
13 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
6 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
8 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1576 |