National Provider Identifier [NPI]: |
1861494098 |
Last Name Of The Provider |
GOOCH |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2135 DANA AVE |
Street Address 2 Of The Provider |
STE 310 |
City Of The Provider |
CINCINNATI |
Zip Code Of The Provider |
452071313 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
1308 |
Number Of Medicare Beneficiaries |
620 |
Total Submitted Charge Amount |
135370 |
Total Medicare Allowed Amount |
110611.43 |
Total Medicare Payment Amount |
74742.25 |
Total Medicare Standardized Payment Amount |
80289.09 |
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 |
20 |
Number Of Medical Services |
1308 |
Number Of Medicare Beneficiaries With Medical Services |
620 |
Total Medical Submitted Charge Amount |
135370 |
Total Medical Medicare Allowed Amount |
110611.43 |
Total Medical Medicare Payment Amount |
74742.25 |
Total Medical Medicare Standardized Payment Amount |
80289.09 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
270 |
Number Of Beneficiaries Age 75 to 84 |
217 |
Number Of Beneficiaries Age Greater 84 |
110 |
Number Of Female Beneficiaries |
378 |
Number Of Male Beneficiaries |
242 |
Number Of Non Hispanic White Beneficiaries |
563 |
Number Of Black or African American Beneficiaries |
40 |
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 |
580 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0518 |