National Provider Identifier [NPI]: |
1508044298 |
Last Name Of The Provider |
SALOMON |
First Name Of The Provider |
VLADIMIR |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
180 E PULASKI RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
HUNTINGTON STATION |
Zip Code Of The Provider |
117461915 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
479 |
Number Of Medicare Beneficiaries |
179 |
Total Submitted Charge Amount |
58285.73 |
Total Medicare Allowed Amount |
37631.71 |
Total Medicare Payment Amount |
27772.11 |
Total Medicare Standardized Payment Amount |
24197.52 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
85 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
4795.8 |
Total Drug Medicare AllowedAmount |
3383.33 |
Total Drug Medicare PaymentAmount |
2577.07 |
Total Drug Medicare Standardized Payment Amount |
2577.07 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
394 |
Number Of Medicare Beneficiaries With Medical Services |
179 |
Total Medical Submitted Charge Amount |
53489.93 |
Total Medical Medicare Allowed Amount |
34248.38 |
Total Medical Medicare Payment Amount |
25195.04 |
Total Medical Medicare Standardized Payment Amount |
21620.45 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
41 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
108 |
Number Of Male Beneficiaries |
71 |
Number Of Non Hispanic White Beneficiaries |
134 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
104 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6872 |