National Provider Identifier [NPI]: |
1407808447 |
Last Name Of The Provider |
GOTTLIEB |
First Name Of The Provider |
SHELDON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4940 EASTERN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212242735 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
1999 |
Number Of Medicare Beneficiaries |
1018 |
Total Submitted Charge Amount |
309334 |
Total Medicare Allowed Amount |
142552.5 |
Total Medicare Payment Amount |
108879.58 |
Total Medicare Standardized Payment Amount |
102835.12 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
1999 |
Number Of Medicare Beneficiaries With Medical Services |
1018 |
Total Medical Submitted Charge Amount |
309334 |
Total Medical Medicare Allowed Amount |
142552.5 |
Total Medical Medicare Payment Amount |
108879.58 |
Total Medical Medicare Standardized Payment Amount |
102835.12 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
248 |
Number Of Beneficiaries Age 65 to 74 |
313 |
Number Of Beneficiaries Age 75 to 84 |
272 |
Number Of Beneficiaries Age Greater 84 |
185 |
Number Of Female Beneficiaries |
507 |
Number Of Male Beneficiaries |
511 |
Number Of Non Hispanic White Beneficiaries |
795 |
Number Of Black or African American Beneficiaries |
193 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
719 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
299 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.4301 |