National Provider Identifier [NPI]: |
1649247198 |
Last Name Of The Provider |
GOODE |
First Name Of The Provider |
JOEL |
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 |
4112 LINKS LN |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
ROUND ROCK |
Zip Code Of The Provider |
786643901 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
267 |
Number Of Medicare Beneficiaries |
87 |
Total Submitted Charge Amount |
38213 |
Total Medicare Allowed Amount |
17224.41 |
Total Medicare Payment Amount |
11518.49 |
Total Medicare Standardized Payment Amount |
12243.57 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
34 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
1663 |
Total Drug Medicare AllowedAmount |
578.37 |
Total Drug Medicare PaymentAmount |
550.34 |
Total Drug Medicare Standardized Payment Amount |
550.34 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
233 |
Number Of Medicare Beneficiaries With Medical Services |
87 |
Total Medical Submitted Charge Amount |
36550 |
Total Medical Medicare Allowed Amount |
16646.04 |
Total Medical Medicare Payment Amount |
10968.15 |
Total Medical Medicare Standardized Payment Amount |
11693.23 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
46 |
Number Of Male Beneficiaries |
41 |
Number Of Non Hispanic White Beneficiaries |
76 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
17 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8501 |