National Provider Identifier [NPI]: |
1902864374 |
Last Name Of The Provider |
SOLOMON |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3698 S MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BLACKSBURG |
Zip Code Of The Provider |
240607015 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
3054 |
Number Of Medicare Beneficiaries |
522 |
Total Submitted Charge Amount |
473287 |
Total Medicare Allowed Amount |
188540.43 |
Total Medicare Payment Amount |
130040.01 |
Total Medicare Standardized Payment Amount |
135269.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
305 |
Number Of Medicare Beneficiaries With Drug Services |
168 |
Total Drug Submitted ChargeAmount |
16892 |
Total Drug Medicare AllowedAmount |
5686.57 |
Total Drug Medicare PaymentAmount |
5116.48 |
Total Drug Medicare Standardized Payment Amount |
5116.48 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
2749 |
Number Of Medicare Beneficiaries With Medical Services |
522 |
Total Medical Submitted Charge Amount |
456395 |
Total Medical Medicare Allowed Amount |
182853.86 |
Total Medical Medicare Payment Amount |
124923.53 |
Total Medical Medicare Standardized Payment Amount |
130152.8 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
255 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
64 |
Number Of Female Beneficiaries |
271 |
Number Of Male Beneficiaries |
251 |
Number Of Non Hispanic White Beneficiaries |
499 |
Number Of Black or African American Beneficiaries |
12 |
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 |
463 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
59 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
27 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0255 |