National Provider Identifier [NPI]: |
1609891316 |
Last Name Of The Provider |
GOEL |
First Name Of The Provider |
NEETA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
44095 PIPELINE PLZ |
Street Address 2 Of The Provider |
STE 370 |
City Of The Provider |
ASHBURN |
Zip Code Of The Provider |
201475898 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
432 |
Number Of Medicare Beneficiaries |
88 |
Total Submitted Charge Amount |
81344.5 |
Total Medicare Allowed Amount |
33049.02 |
Total Medicare Payment Amount |
23053.61 |
Total Medicare Standardized Payment Amount |
24063.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
49 |
Number Of Medicare Beneficiaries With Drug Services |
41 |
Total Drug Submitted ChargeAmount |
3502.5 |
Total Drug Medicare AllowedAmount |
1687.08 |
Total Drug Medicare PaymentAmount |
1653.15 |
Total Drug Medicare Standardized Payment Amount |
1653.15 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
383 |
Number Of Medicare Beneficiaries With Medical Services |
88 |
Total Medical Submitted Charge Amount |
77842 |
Total Medical Medicare Allowed Amount |
31361.94 |
Total Medical Medicare Payment Amount |
21400.46 |
Total Medical Medicare Standardized Payment Amount |
22410.24 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
59 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
64 |
Number Of Male Beneficiaries |
24 |
Number Of Non Hispanic White Beneficiaries |
58 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
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 |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
17 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
17 |
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 |
0.8967 |