National Provider Identifier [NPI]: |
1942343348 |
Last Name Of The Provider |
TARR |
First Name Of The Provider |
ADDISON |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
50 N PERRY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PONTIAC |
Zip Code Of The Provider |
483422217 |
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 |
22 |
Number Of Services |
683 |
Number Of Medicare Beneficiaries |
567 |
Total Submitted Charge Amount |
721982 |
Total Medicare Allowed Amount |
95503.25 |
Total Medicare Payment Amount |
74493.14 |
Total Medicare Standardized Payment Amount |
76508.84 |
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 |
22 |
Number Of Medical Services |
683 |
Number Of Medicare Beneficiaries With Medical Services |
567 |
Total Medical Submitted Charge Amount |
721982 |
Total Medical Medicare Allowed Amount |
95503.25 |
Total Medical Medicare Payment Amount |
74493.14 |
Total Medical Medicare Standardized Payment Amount |
76508.84 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
181 |
Number Of Beneficiaries Age 65 to 74 |
153 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
329 |
Number Of Male Beneficiaries |
238 |
Number Of Non Hispanic White Beneficiaries |
548 |
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 |
328 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
239 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.7154 |