National Provider Identifier [NPI]: |
1770543894 |
Last Name Of The Provider |
BORBOROGLU |
First Name Of The Provider |
PRODROMOS |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
575 S WICKHAM RD |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
WEST MELBOURNE |
Zip Code Of The Provider |
329041170 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
126 |
Number Of Services |
7723 |
Number Of Medicare Beneficiaries |
1037 |
Total Submitted Charge Amount |
1970224.17 |
Total Medicare Allowed Amount |
803927.27 |
Total Medicare Payment Amount |
608902.15 |
Total Medicare Standardized Payment Amount |
619668.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
1400 |
Number Of Medicare Beneficiaries With Drug Services |
136 |
Total Drug Submitted ChargeAmount |
16091 |
Total Drug Medicare AllowedAmount |
2939.03 |
Total Drug Medicare PaymentAmount |
2121.94 |
Total Drug Medicare Standardized Payment Amount |
2121.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
120 |
Number Of Medical Services |
6323 |
Number Of Medicare Beneficiaries With Medical Services |
1037 |
Total Medical Submitted Charge Amount |
1954133.17 |
Total Medical Medicare Allowed Amount |
800988.24 |
Total Medical Medicare Payment Amount |
606780.21 |
Total Medical Medicare Standardized Payment Amount |
617546.65 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
106 |
Number Of Beneficiaries Age 65 to 74 |
430 |
Number Of Beneficiaries Age 75 to 84 |
341 |
Number Of Beneficiaries Age Greater 84 |
160 |
Number Of Female Beneficiaries |
292 |
Number Of Male Beneficiaries |
745 |
Number Of Non Hispanic White Beneficiaries |
878 |
Number Of Black or African American Beneficiaries |
72 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
61 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
888 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
149 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.6063 |