National Provider Identifier [NPI]: |
1407856990 |
Last Name Of The Provider |
SODHA |
First Name Of The Provider |
SAMIR |
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 |
95 CRYSTAL RUN RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MIDDLETOWN |
Zip Code Of The Provider |
109417001 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
131 |
Number Of Services |
3823 |
Number Of Medicare Beneficiaries |
567 |
Total Submitted Charge Amount |
840120 |
Total Medicare Allowed Amount |
280010.28 |
Total Medicare Payment Amount |
213276.53 |
Total Medicare Standardized Payment Amount |
204589.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
2093 |
Number Of Medicare Beneficiaries With Drug Services |
270 |
Total Drug Submitted ChargeAmount |
87705 |
Total Drug Medicare AllowedAmount |
40765.98 |
Total Drug Medicare PaymentAmount |
31909.89 |
Total Drug Medicare Standardized Payment Amount |
31909.89 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
127 |
Number Of Medical Services |
1730 |
Number Of Medicare Beneficiaries With Medical Services |
567 |
Total Medical Submitted Charge Amount |
752415 |
Total Medical Medicare Allowed Amount |
239244.3 |
Total Medical Medicare Payment Amount |
181366.64 |
Total Medical Medicare Standardized Payment Amount |
172679.94 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
116 |
Number Of Beneficiaries Age 65 to 74 |
267 |
Number Of Beneficiaries Age 75 to 84 |
139 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
350 |
Number Of Male Beneficiaries |
217 |
Number Of Non Hispanic White Beneficiaries |
482 |
Number Of Black or African American Beneficiaries |
21 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
37 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
467 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
100 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1449 |