National Provider Identifier [NPI]: |
1770715633 |
Last Name Of The Provider |
BAGATTO |
First Name Of The Provider |
AMY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 EAST MEDICAL CENTER DRIVE |
Street Address 2 Of The Provider |
3RD FLOOR TAUBMAN CENTER RECP B |
City Of The Provider |
ANN ARBOR |
Zip Code Of The Provider |
481095352 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
530 |
Number Of Medicare Beneficiaries |
185 |
Total Submitted Charge Amount |
106215 |
Total Medicare Allowed Amount |
49665.42 |
Total Medicare Payment Amount |
38573.45 |
Total Medicare Standardized Payment Amount |
37549.01 |
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 |
14 |
Number Of Medical Services |
530 |
Number Of Medicare Beneficiaries With Medical Services |
185 |
Total Medical Submitted Charge Amount |
106215 |
Total Medical Medicare Allowed Amount |
49665.42 |
Total Medical Medicare Payment Amount |
38573.45 |
Total Medical Medicare Standardized Payment Amount |
37549.01 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
98 |
Number Of Male Beneficiaries |
87 |
Number Of Non Hispanic White Beneficiaries |
149 |
Number Of Black or African American Beneficiaries |
24 |
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 |
123 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.612 |