National Provider Identifier [NPI]: |
1306824305 |
Last Name Of The Provider |
GOODJOIN |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
105 CARNEGIE PL |
Street Address 2 Of The Provider |
SUITE 103 |
City Of The Provider |
FAYETTEVILLE |
Zip Code Of The Provider |
302143980 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
67 |
Number Of Services |
4191 |
Number Of Medicare Beneficiaries |
658 |
Total Submitted Charge Amount |
424690.24 |
Total Medicare Allowed Amount |
180686.19 |
Total Medicare Payment Amount |
128874.74 |
Total Medicare Standardized Payment Amount |
129946.38 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
1655 |
Number Of Medicare Beneficiaries With Drug Services |
223 |
Total Drug Submitted ChargeAmount |
36013.75 |
Total Drug Medicare AllowedAmount |
5469.16 |
Total Drug Medicare PaymentAmount |
4512.57 |
Total Drug Medicare Standardized Payment Amount |
4512.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
55 |
Number Of Medical Services |
2536 |
Number Of Medicare Beneficiaries With Medical Services |
658 |
Total Medical Submitted Charge Amount |
388676.49 |
Total Medical Medicare Allowed Amount |
175217.03 |
Total Medical Medicare Payment Amount |
124362.17 |
Total Medical Medicare Standardized Payment Amount |
125433.81 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
115 |
Number Of Beneficiaries Age 65 to 74 |
288 |
Number Of Beneficiaries Age 75 to 84 |
174 |
Number Of Beneficiaries Age Greater 84 |
81 |
Number Of Female Beneficiaries |
415 |
Number Of Male Beneficiaries |
243 |
Number Of Non Hispanic White Beneficiaries |
309 |
Number Of Black or African American Beneficiaries |
318 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
541 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
117 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.4495 |