National Provider Identifier [NPI]: |
1235103425 |
Last Name Of The Provider |
SAMUELS |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4300 ALTON RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MIAMI BEACH |
Zip Code Of The Provider |
331402800 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
1551 |
Number Of Medicare Beneficiaries |
169 |
Total Submitted Charge Amount |
430055 |
Total Medicare Allowed Amount |
120224.36 |
Total Medicare Payment Amount |
92556.12 |
Total Medicare Standardized Payment Amount |
85735.54 |
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 |
28 |
Number Of Medical Services |
1551 |
Number Of Medicare Beneficiaries With Medical Services |
169 |
Total Medical Submitted Charge Amount |
430055 |
Total Medical Medicare Allowed Amount |
120224.36 |
Total Medical Medicare Payment Amount |
92556.12 |
Total Medical Medicare Standardized Payment Amount |
85735.54 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
90 |
Number Of Beneficiaries Age 75 to 84 |
42 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
26 |
Number Of Male Beneficiaries |
143 |
Number Of Non Hispanic White Beneficiaries |
78 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
75 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
96 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
73 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
42 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.9491 |