National Provider Identifier [NPI]: |
1710988746 |
Last Name Of The Provider |
GOLDEN |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12615 E MISSION AVE |
Street Address 2 Of The Provider |
STE 303 |
City Of The Provider |
SPOKANE VALLEY |
Zip Code Of The Provider |
992161047 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
84 |
Number Of Services |
2589 |
Number Of Medicare Beneficiaries |
817 |
Total Submitted Charge Amount |
450150.5 |
Total Medicare Allowed Amount |
285371.4 |
Total Medicare Payment Amount |
215348.86 |
Total Medicare Standardized Payment Amount |
219651.35 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
430 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
58136.96 |
Total Drug Medicare AllowedAmount |
47445.93 |
Total Drug Medicare PaymentAmount |
37067.57 |
Total Drug Medicare Standardized Payment Amount |
37067.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
2159 |
Number Of Medicare Beneficiaries With Medical Services |
817 |
Total Medical Submitted Charge Amount |
392013.54 |
Total Medical Medicare Allowed Amount |
237925.47 |
Total Medical Medicare Payment Amount |
178281.29 |
Total Medical Medicare Standardized Payment Amount |
182583.78 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
301 |
Number Of Beneficiaries Age 75 to 84 |
300 |
Number Of Beneficiaries Age Greater 84 |
135 |
Number Of Female Beneficiaries |
188 |
Number Of Male Beneficiaries |
629 |
Number Of Non Hispanic White Beneficiaries |
784 |
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 |
710 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
107 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4343 |