National Provider Identifier [NPI]: |
1083722219 |
Last Name Of The Provider |
GOLDSTEIN |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1301 PENNSYLVANIA AVE STE 411 |
Street Address 2 Of The Provider |
|
City Of The Provider |
DES MOINES |
Zip Code Of The Provider |
503162367 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
105 |
Number Of Services |
427 |
Number Of Medicare Beneficiaries |
219 |
Total Submitted Charge Amount |
376496 |
Total Medicare Allowed Amount |
123045.72 |
Total Medicare Payment Amount |
95769.38 |
Total Medicare Standardized Payment Amount |
104345.85 |
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 |
105 |
Number Of Medical Services |
427 |
Number Of Medicare Beneficiaries With Medical Services |
219 |
Total Medical Submitted Charge Amount |
376496 |
Total Medical Medicare Allowed Amount |
123045.72 |
Total Medical Medicare Payment Amount |
95769.38 |
Total Medical Medicare Standardized Payment Amount |
104345.85 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
114 |
Number Of Male Beneficiaries |
105 |
Number Of Non Hispanic White Beneficiaries |
204 |
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 |
173 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1157 |