National Provider Identifier [NPI]: |
1104114875 |
Last Name Of The Provider |
SEGAL |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5601 LOCH RAVEN BLVD |
Street Address 2 Of The Provider |
SUITE 307 |
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212392945 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
108 |
Number Of Services |
6374 |
Number Of Medicare Beneficiaries |
651 |
Total Submitted Charge Amount |
508829.5 |
Total Medicare Allowed Amount |
253814.58 |
Total Medicare Payment Amount |
188224.69 |
Total Medicare Standardized Payment Amount |
181892.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
4052 |
Number Of Medicare Beneficiaries With Drug Services |
27 |
Total Drug Submitted ChargeAmount |
150263 |
Total Drug Medicare AllowedAmount |
73702.82 |
Total Drug Medicare PaymentAmount |
56364.12 |
Total Drug Medicare Standardized Payment Amount |
56364.12 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
101 |
Number Of Medical Services |
2322 |
Number Of Medicare Beneficiaries With Medical Services |
651 |
Total Medical Submitted Charge Amount |
358566.5 |
Total Medical Medicare Allowed Amount |
180111.76 |
Total Medical Medicare Payment Amount |
131860.57 |
Total Medical Medicare Standardized Payment Amount |
125528.59 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
137 |
Number Of Beneficiaries Age 65 to 74 |
222 |
Number Of Beneficiaries Age 75 to 84 |
182 |
Number Of Beneficiaries Age Greater 84 |
110 |
Number Of Female Beneficiaries |
157 |
Number Of Male Beneficiaries |
494 |
Number Of Non Hispanic White Beneficiaries |
280 |
Number Of Black or African American Beneficiaries |
353 |
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 |
452 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
199 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
24 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.7106 |