National Provider Identifier [NPI]: |
1063695658 |
Last Name Of The Provider |
GOYAL |
First Name Of The Provider |
RAJAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3231 S NATIONAL AVE |
Street Address 2 Of The Provider |
STE 240 |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658077304 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
2311 |
Number Of Medicare Beneficiaries |
741 |
Total Submitted Charge Amount |
553131 |
Total Medicare Allowed Amount |
206510.91 |
Total Medicare Payment Amount |
156665.93 |
Total Medicare Standardized Payment Amount |
166834.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
16 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
824 |
Total Drug Medicare AllowedAmount |
602.6 |
Total Drug Medicare PaymentAmount |
590.55 |
Total Drug Medicare Standardized Payment Amount |
590.55 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
50 |
Number Of Medical Services |
2295 |
Number Of Medicare Beneficiaries With Medical Services |
741 |
Total Medical Submitted Charge Amount |
552307 |
Total Medical Medicare Allowed Amount |
205908.31 |
Total Medical Medicare Payment Amount |
156075.38 |
Total Medical Medicare Standardized Payment Amount |
166243.61 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
178 |
Number Of Beneficiaries Age 65 to 74 |
302 |
Number Of Beneficiaries Age 75 to 84 |
198 |
Number Of Beneficiaries Age Greater 84 |
63 |
Number Of Female Beneficiaries |
349 |
Number Of Male Beneficiaries |
392 |
Number Of Non Hispanic White Beneficiaries |
711 |
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 |
555 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
186 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
61 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.8022 |