National Provider Identifier [NPI]: |
1043258759 |
Last Name Of The Provider |
GOLDMAKHER |
First Name Of The Provider |
TERA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
33155 ANNAPOLIS ST |
Street Address 2 Of The Provider |
EMERGENCY DEPT |
City Of The Provider |
WAYNE |
Zip Code Of The Provider |
481842405 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
866 |
Number Of Medicare Beneficiaries |
629 |
Total Submitted Charge Amount |
582016 |
Total Medicare Allowed Amount |
123821.98 |
Total Medicare Payment Amount |
91428.1 |
Total Medicare Standardized Payment Amount |
87710.18 |
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 |
18 |
Number Of Medical Services |
866 |
Number Of Medicare Beneficiaries With Medical Services |
629 |
Total Medical Submitted Charge Amount |
582016 |
Total Medical Medicare Allowed Amount |
123821.98 |
Total Medical Medicare Payment Amount |
91428.1 |
Total Medical Medicare Standardized Payment Amount |
87710.18 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
277 |
Number Of Beneficiaries Age 65 to 74 |
160 |
Number Of Beneficiaries Age 75 to 84 |
117 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
334 |
Number Of Male Beneficiaries |
295 |
Number Of Non Hispanic White Beneficiaries |
413 |
Number Of Black or African American Beneficiaries |
199 |
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 |
305 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
324 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
27 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
51 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.3568 |