National Provider Identifier [NPI]: |
1598755449 |
Last Name Of The Provider |
POGODZINSKI |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
374 MDOS/SGOSL |
Street Address 2 Of The Provider |
|
City Of The Provider |
APO |
Zip Code Of The Provider |
96328 |
State Code Of The Provider |
ZZ |
Country Code Of The Provider |
JP |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
68 |
Number Of Services |
1626 |
Number Of Medicare Beneficiaries |
558 |
Total Submitted Charge Amount |
459614.7 |
Total Medicare Allowed Amount |
177867.99 |
Total Medicare Payment Amount |
133984.11 |
Total Medicare Standardized Payment Amount |
123649.55 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
188 |
Number Of Beneficiaries Age 75 to 84 |
161 |
Number Of Beneficiaries Age Greater 84 |
117 |
Number Of Female Beneficiaries |
343 |
Number Of Male Beneficiaries |
215 |
Number Of Non Hispanic White Beneficiaries |
385 |
Number Of Black or African American Beneficiaries |
81 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
57 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
355 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
203 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.601 |