National Provider Identifier [NPI]: |
1831231661 |
Last Name Of The Provider |
GHIDE |
First Name Of The Provider |
SOLOMON |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1111 MEDICAL PLAZA DR |
Street Address 2 Of The Provider |
SUITE 250 |
City Of The Provider |
THE WOODLANDS |
Zip Code Of The Provider |
773803476 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
1402 |
Number Of Medicare Beneficiaries |
409 |
Total Submitted Charge Amount |
201820 |
Total Medicare Allowed Amount |
132672.13 |
Total Medicare Payment Amount |
103759.34 |
Total Medicare Standardized Payment Amount |
109873.63 |
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 |
13 |
Number Of Medical Services |
1402 |
Number Of Medicare Beneficiaries With Medical Services |
409 |
Total Medical Submitted Charge Amount |
201820 |
Total Medical Medicare Allowed Amount |
132672.13 |
Total Medical Medicare Payment Amount |
103759.34 |
Total Medical Medicare Standardized Payment Amount |
109873.63 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
120 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
229 |
Number Of Male Beneficiaries |
180 |
Number Of Non Hispanic White Beneficiaries |
346 |
Number Of Black or African American Beneficiaries |
35 |
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 |
336 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
73 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.5534 |