National Provider Identifier [NPI]: |
1689649964 |
Last Name Of The Provider |
SOLOMON |
First Name Of The Provider |
LOUIS |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1600 SW ARCHER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GAINESVILLE |
Zip Code Of The Provider |
326103003 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
2488 |
Number Of Medicare Beneficiaries |
166 |
Total Submitted Charge Amount |
933208 |
Total Medicare Allowed Amount |
220553.48 |
Total Medicare Payment Amount |
169547.95 |
Total Medicare Standardized Payment Amount |
171550.05 |
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 |
2488 |
Number Of Medicare Beneficiaries With Medical Services |
166 |
Total Medical Submitted Charge Amount |
933208 |
Total Medical Medicare Allowed Amount |
220553.48 |
Total Medical Medicare Payment Amount |
169547.95 |
Total Medical Medicare Standardized Payment Amount |
171550.05 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
103 |
Number Of Male Beneficiaries |
63 |
Number Of Non Hispanic White Beneficiaries |
145 |
Number Of Black or African American Beneficiaries |
|
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 |
95 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
71 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
41 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6968 |